Lab Values That Matter For Athletes (and why doctors shouldn't do nutrition) Ep 148

Most athletes get routine blood work.

Very few understand which biomarkers truly matter for performance, recovery, and longevity.

In this episode of Find Your Edge, Coach Chris Newport and dietetic intern Emily Qiu break down the special lab values endurance athletes should know about and why they matter.

We discuss:

• CBC and CMP basics
• ApoB and cardiovascular risk
• Magnesium and athletic performance
• Vitamin B12 and MMA
• Homocysteine and longevity
• Vitamin D and bone health
• Why athletes need personalized interpretation
• How biomarker trends help you make smarter decisions

If you've ever felt like you're doing everything right but still not seeing the results you want, this episode is for you.

Because the goal isn't more information.

The goal is clarity.

Learn more about the Endurance Edge Longevity Lab:
https://www.theenduranceedge.com/longevity/

Check out the episode here: https://www.theenduranceedge.com/special-lab-values-endurance-athletes-biomarkers

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Join us for an Ultimate Training Day and receive personalized coaching, hands-on swim, bike, and run instruction, and actionable feedback you can use immediately. 

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Transcript

Why Athletes Need Better Lab Context

Coach Carlie 0:00

All right, welcome back to the Find Your Edge podcast. I am your host, Coach Chris Newport. And today's topic is a fun, nerdy one, special lab values of interest, in particular for athletes and endurance athletes, of course, because you know you're our people. And I want to back up a little bit because when I first started practicing and I would have folks come in for nutrition consults, I would be giving them a list, like writing them out a little, like here are the things that I want you to go to your doctor and ask them, pretty please, to order because dietitians are in a little bit of a special bucket. We cannot order labs. We have found a little bit of a loophole to that. So now we're able to get them without necessarily having to go through your doctor because sometimes, in defense of doctors, sometimes they can't order something specific because they don't have an appropriate diagnosis code. And they can't just be like, well, yes, wouldn't it be sure, wouldn't it be nice to know some of these things, but we can't get it through your insurance company. They're probably not going to pay for it. And why are we doing this anyway without a more specific diagnosis code? Right. So there's that whole thing. And then now we're getting into this age of direct-to-consumer labs where you go through a particular company. I won't necessarily name any of them, but there's several of them on the market where you're just like, okay, you know, let's get all these biometrics, but you don't necessarily know, nor should you know what they mean. And then if there's anything that's out of the ordinary, people generally freak out and they're like, this one number is off. And then what does this mean? Oh my gosh. And then they're not able to, because why should they? They're not a healthcare provider. They're not able to zoom out and take into account a more holistic view rather than just picking and parting one number that might be out of normal limits. When in my mind, I'm trying to work in more functional limits because you guys are high performers. Generally, most of you are healthy. There are other things that are obviously going on. Some we we work with a lot of celiac disease. We work with a lot of Hashimoto's and graves and hypothyroidism and high cholesterol, whether it be genetic or not, or whatever. Every once in a while we've got some hypertension, uh, we've got fertility, we've got perimenopause, menopause, like all of those things depend on where you are in your life stage. What are your goals for your sport? And then what are the things that we want to hone in on that are also related to your genetics? So we've got all these different pieces. So I think of labs as what are the metrics that we should be tracking on a regular basis? And then what are maybe some of the metrics that are more specific to you and what you're trying to achieve. So, all of that to say is that these special labs are special. You're special. So having said that, Emily Q is here. She is my dietary intern, and she uh did some really great homework because, of course, she's been hearing it from me and been hearing it in our longevity lab program that we have of all the different labs that we have access to that we can get for people and start to look at trends and then have someone with you have a healthcare provider who is with you interpreting these and then helping you either get follow-up care or adjust accordingly from a diet, lifestyle, or supplement perspective. So, anyway, Emily, thanks for coming. Of course, I'm happy to be here. I think I've had too much coffee. So, for those of you guys who are listening right now, we're doing a couple of back-to-back episodes. And I I was on a bit of a rant in the last episode. So here we are. Welcome all the rants.

SPEAKER_01 4:11

I I I love the high-energy stuff.

Coach Carlie 4:13

Okay, cool. All right, so let's get into it. What are the these are like some standard labs that you would see just and these are like, you guys, these are like dirt cheap. And when I say dirt cheap, I mean like really dirt cheap. Anyway, talk us through these, Emily. I will, I promise I wouldn't grab.

SPEAKER_01 4:34

No, say something if you got something to say. But first of all, just wanted

The Standard Panels To Request

SPEAKER_01 4:39

to go through the like kind of more standard lab panels. You probably, if you go to your PCP like every year or something like that, they'll probably run these just to make they're just like really basic labs for screening for really common conditions like you know, cardiovascular disease, diabetes, anemia. So they just want to make sure everything's good on all those ends. They're probably gonna have um a complete blood count or a CBC. This is measuring um your red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. This is like a screening for anemia mainly. You also you're also gonna have some sort of metabolic panel, either a basic, a BMP, or a comprehensive, a CMP. That will probably get you your fasting glucose, serum calcium, electrolytes, like sodium and potassium and all that stuff, BUN and creatinine, which are measures of kidney function. You're and then the CMP will add on liver enzymes, bilirubin for just overall liver function, and then also total protein and albumin.

Coach Carlie 5:43

Yes. Love that. So cool. And then what else, generally speaking, are you gonna do at like a physical? You get CBC, you get a CMP or a BMP, and then what else?

SPEAKER_01 5:53

You'll probably see the lipid panel. This will tell you your uh total triglycerides in your blood, your total cholesterol, as well as the subcategories of cholesterol. You've probably heard of the LDL, which is the quote unquote bad cholesterol, and then the HDL, which is the, I guess they call it the good cholesterol. So you'll see all those. Something that's getting more common now is hemoglobin A1C. That's going to measure your overall uh blood glucose for the last like two to three-ish months. It's a good indicator of prediabetes or diabetes if it's in certain ranges. And then sometimes an iron panel, if they're if you like ask for one, if they're concerned about anemia. For athletes, I feel like the iron panel is important, but they don't always do it.

Coach Carlie 6:40

Yeah. Because usually it's you're not gonna get triggered with an iron panel unless you complain about some sort of excess fatigue. Sorry, you guys, you're athletes. At some point you're gonna get tired. Like it's like it's just part of the equation, but oftentimes that's not gonna be triggered unless your hemoglobin or hermatocrit are low. And that's not an automatic thing that means your ferritin is low or your iron panel is off. So I always encourage folks to try to get that one tested. Um, and we have seen a couple of people who have done our genetic testing do have the hemochromatosis gene and did not know it. So if they had had their iron panel run, they probably would have been triggered to be like, huh, something is awry. Yeah. So, okay. So that's just kind of like the standard deal. Generally speaking, you do usually have to ask for an A1C, you do usually have to ask for an iron panel, and then I all I like to add in ferritin to go along with the iron panel. Um for sure. Yeah. So, but CBCs and CMPs are like does get run all the time. And they're again, like I said, dirt cheap. Okay. Ooh, this is a good one. So yay! We've got some relational workers of heart health. So tell us apolipoprotein B.

SPEAKER_01 8:06

Yeah. So now we're gonna try to get into some of the ones that are like less known or understood, or just kind of if a lot of your your normal labs are fine, but you still have concerns, these are some that you can measure to just check on things. So apolipoprotein

ApoB And Real Cardiovascular Risk

SPEAKER_01 8:22

B, or apoplee for short, this is a protein that's found on the surface of LDL and VLDL cholesterol, which as we uh said earlier is kind of like the quote unquote bad cholesterol that we we want to reduce.

Coach Carlie 8:37

Yes. And more specifically, because everybody thinks of all LDLs being bad, they're not all bad. They're not all bad. Right. But the VLDLs are bad. Some LDLs are like, I like to describe them as like big dopey cotton balls that just like, you know, float around in your blood and they're just kind of, you know, whatever. They're not necessarily hurting anything. But the VLDLs are like really very low density blood proteins. So they're very, they're like BB guns. And those are the ones that go through your system and pick off those plaques that are no bueno. So go ahead.

SPEAKER_01 9:13

So you might be wondering, like, okay, why is this different than like the standard lipid panel and what they measure there? So the standard lipid panel, when they measure your LDL, they're measuring like the weight, or I guess you could say the concentration of LDL in the blood in total. While the APOB test is really going to measure how many particles you have, how many LEL particles you have, which can be it can be different because you could have an like an average or normal concentration of LDL in the blood, but somebody who has a lot more of like the cotton ball-y type LDL. Big dopey was saying, yes, the big dopey ones, it's gonna be a very different cardiovascular risk than somebody who has a lot of smaller, denser particles. And like they're gonna, and the APOB test will show the difference between those. They could the because each molecule only has one APOB. So the APOB will give you an accurate count of how many particles you have, as opposed to just how much space it takes up in your blood. Yeah.

Coach Carlie 10:22

Cool. And then yeah, I like how you really emphasized here the higher sensitivity and the specificity. APOB proving to have higher sensitivity and specificity than LDL cholesterol alone, right? Because so many people are like, oh, your LDL is high. Let's put you on a stat. And it's like, no, no, no, let's get more information. So better marker of predicting cardiovascular risk, right? Exactly.

SPEAKER_01 10:46

Yeah. It's usually more recommended to get an APOB test if you have either high triglycerides, if you have metabolic syndrome, type 2 diabetes, or a family history of cardiovascular disease. Because you could be showing higher LDL because of like a genetic thing, but maybe like you're not actually like super at risk for cardiovascular events based on your APOB test. You never know.

Coach Carlie 11:14

And of course, you know, we're all nerds here, and uh, we test this because we can in our longevity lab, because we just want a bigger picture uh because that's why people come to us, right? They oftentimes your standard healthcare provider is like, they don't get the fact that I'm doing Iron Man or I'm riding my bike for multiple hours a day, or you know, even if you're not, even if you're doing sprint triathlons, they're like, wait, what? You know, well, let's just put you on a stat and you're like, but I you know, and then they're like, be sure to exercise. And you're like, oh my God, do you know what I like? Do you know how much I exercise? Like, this is it's like, no, I've got that covered. Yeah, I've got that heart covered. Can you not send me this like really lame note in the portal that's like, be sure to exercise and eat your vegetables? You're like, you got, I mean, come on, you guys. So uh, and that sounded really rude to all physicians out there. I'm so so I'm not it's our medical system is created more for is more of a sick model. It's more for treating disease. So why can't we know what this number is on a more regular basis? So in our longevity lab, we test this annually because we can. Like, why not have the markers to be proactive about our health rather than, oh, now I see your LDL is high. Let's go ahead and do all the other numbers when I could have been done doing something about this two years ago, three years ago, 10 years ago, before I even had to know any of this stuff.

SPEAKER_01 12:45

Like preventative rather than reactive. Yes, 100%.

Coach Carlie 12:48

Yes. Okay, what else do we want to know about? Let's get into this guy.

SPEAKER_01 12:52

Okay, another really good one is magnesium, which I feel like has been getting more hype recently. It's so important. Magnesium is required by every organ in the body. It's in over 300 biochemical reactions. That's bananas, if you think about it. Isn't it?

Coach Carlie 13:09

Yeah.

SPEAKER_01 13:10

Yeah. Keep going.

Coach Carlie 13:12

I love this in the body. It's so awesome.

SPEAKER_01 13:15

It's involved in

Magnesium Testing Beyond Serum Levels

SPEAKER_01 13:17

so many different processes, like the just to name a few protein synthesis, muscle and nerve function, blood glucose control, energy production, all such important like big things. And we know that magnesium deficiency is super common. And a lot of people suffer maybe some symptoms that they don't know that it's because of their magnesium. It's also kind of uh fickle to measure. So a lot of the times, if you want your magnesium measured, they'll uh the lab that will be done is a serum magnesium test uh that'll measure the level of magnesium in your blood, but uh it's not always like super accurate because most of your magnesium is actually in your cells. So um you would really rather get a test that measures the magnesium content in your red blood cells, but that can be more expensive sometimes.

Coach Carlie 14:12

Yes. Yeah, that's uh for anybody in our longevity lab, that's what we test. Because again, we want a better reflection of what's actually going on. And of course, working with athletes, um, I'm sorry, has anybody not cramped before? Or had some sort of muscle issue or fatigue or things like that, you know, and we're losing it in sweat. We're losing magnesium in sweat, and it's not something that's necessarily well stored. We have to get it from food, which I love that you have foods high in magnesium. So for those people who are listening and not watching, you gotta name them off, Emily, because yeah, this is so I will for sure.

SPEAKER_01 14:52

You've got uh pumpkin seeds, black beans, quinoa, flax seeds, Brazil nuts, edamame, cheese seeds, you're probably seeing a pattern here. It's a lot of nuts and beans and seeds. I do want to mention on that list is also dark chocolate.

Coach Carlie 15:09

So for those out there who like dark chocolate, like not first.

SPEAKER_01 15:16

Yeah. But it for a lot of people, it is hard to get a lot of these foods in like super regularly.

Coach Carlie 15:21

So you know, leafy greens. I know they're not specifically on that list, but yeah. But yeah, leafy greens for sure. Yeah, it can be a harder sell. I get it. And some people just, you know, listen, if you have preferences, you have preferences. Like, no, it's okay. I I remember just being like it's so annoyed when I first started practicing, like, eat your leafy greens, you guys. And then I'm like, you know what? Whatever. We all have different palettes, let's work around it. Like, it's like if you're being a brat about it, it's one thing. But if you just can't have it, it's another thing. So anyway, I think you have one more point on magnesium and then yeah.

SPEAKER_01 16:02

Just because magnesium is so crucial in all these important processes, if you chronically have low magnesium, it can just put you at risk for abnormal heart rhythms and increase your long-term risk of type 2 diabetes and osteoporosis, which no one wants. So if you notice that like you don't really eat much of these foods, you might want to get your magnesium checked out and just just be sure you're on the right track.

Coach Carlie 16:26

We've had folks who are are in this situation and they go through full cardiac workups, which is not bad, not a bad thing. Listen, I'm I'm so here for it. But then they're finding, like, oh, I just needed some magnesium. And then I'm I'm good. But again, I'll I'm all for the workout for sure. Okay, what's our what's our next uh lab marker?

SPEAKER_01 16:47

All right, vitamin B12, also a very important nutrient that's involved in a ton of processes. Making your red blood cells, which take your oxygen around your body, making nerves, making DNA and energy, even more than that. We know that B12 deficiency is common in older adults and vegetarians and vegans because uh B12

B12 Status MMA And Homocysteine

SPEAKER_01 17:12

is only found naturally in animal sources of foods. Anyone who's not looking at the slide right now, I've got some pictures of like chicken and cheese and meat and eggs and dairy and all that stuff.

Coach Carlie 17:26

Yep, for sure. And this is dependent on, I know that you mentioned here like an underlying GI issue. We talked about this in the bone health podcast too, that in order to adequately absorb B12, you need something called intrinsic factor, which is starts at the initial part of digestion in the stomach. And if you're on proton pump inhibitors, if you're taking lots of antacids, you could have a B12 deficiency, which of course is really important when you are trying to push your body to the limits and doing all these athletic endeavors. So, you know, we want to make sure that we're doing good things here. Also, there are genetic links to vitamin B12 and making sure that you know those, first of all, so that you can optimize and track more effectively. MMA, did you talk about MMA and not the sport?

SPEAKER_01 18:21

Not yet. Yeah, let's let's talk about it. So uh kind of like with the whole like magnesium thing, sometimes just measuring like your serum B12 is not going to be the most accurate picture of your B12 status. There's a compound called methylmalonic acid or MMA, uh, because that's kind of a mouthful. It's um a metab a metabolite that requires B12 to convert back into usable energy for the body. And so if you uh it can better measure your B12 status because it accumulates faster than um the deficiency in B12 like shows up. So basically, if you measure your MMA through your it's uh either the blood or urine test, and you see that it's elevated, even though your B12 levels are normal, that can be an indicator that there's not as much B12 as you need to convert all that MMA back to energy if you see it accumulating. Yeah, interesting, cool.

Coach Carlie 19:26

And again, no shocker, folks, this is in our longevity lab. And again, we're here to help you translate all this to what does that mean to the food that you need to be eating, supplement strategy in the exercise plan.

SPEAKER_01 19:37

Right. Especially if you fall into one of the camps of being like an old older adults or vegetarians and vegans, you might want to consider supplementing.

Coach Carlie 19:46

Yes, and again, nothing wrong with you or if you're if you're a vegetarian or vegan, like it's fine, it's all good. We can work around that. But you know, know your genetics and know your numbers. There you go. Okay, cool. Ooh, and on the line of um B12, homocysteine.

SPEAKER_01 20:05

Homocysteine.

Coach Carlie 20:06

Yes.

SPEAKER_01 20:07

Yes, it's very closely related to B12. So um we we know that homocysteine is a natural byproduct of metabolizing methionine. You might have heard of methionine before. It's an essential amino acid that or EAAs is we all like to, you know, uh abbreviate everything.

Coach Carlie 20:27

I get I get my EAAs. I'm like, okay, good. All right, cool.

SPEAKER_01 20:32

Yeah.

Coach Carlie 20:32

Methionine is a little bit.

SPEAKER_01 20:35

Yeah, you'll just get that in like regular protein and your body will like break it down. So when your body processes methionine, homocysteine is just kind of it's a product of that process. And we know that B12 plays a huge role in converting homocysteine back into methionine, and B6 kind of helps convert it to a different amino acid called cysteine. So a lot of B vitamins are working to convert homocysteine into other things. So if you're deficient in any in the specific B vitamins that play a role, B6, folate, or B12, if you're deficient in any of those, that process is a lot less efficient. And so you'll see an elevated level of homocysteine in your blood.

Coach Carlie 21:22

All right. So, did we go over all of those things? Some cardiovascular outcomes. Also, I love this picture that you have if you guys are watching on YouTube. It's bringing me back to my biochem days. Biochem, yep. All the diagrams, all the processes. All the processes, yep. So I do like, I do want to point out in that process off to the left, because so many of us are getting things that are fortified. Anything that's fortified, which again, not necessarily anything wrong with it, but when you see folic acid needs to be converted to five methyl tetrahydrofoliate and goes through that whole process. Of supporting B12 and all this entire breakdown, some of us just don't convert very well the synthetic version of folic acid to the methylated version of folate. So, anyway, side note on that. And same thing with methylated B12 versus the synthetic version, which is often cyanocobalamin. So if you are taking a multivitamin, look at the label. If you bought it off of the grocery store shelves and it says cyanocobalamin, that is attached to a molecule of cyanide. Nobody needs that. So get on a better quality vitamin, talk to your local dietitian, reach out to us. We're happy to help you with that whole process. But you know, I'm on a mission to get people on better quality vitamins and whole foods so that they can do this little diagram all by their lonesome selves. Yeah, like do it efficiently. Do it if I'm all I'm all for efficiency. Anyway, what else do you want to say about homocysteine?

SPEAKER_01 23:05

Yeah. So in addition to all those like vitamin deficiencies that elevated homocysteine can catch, we also don't want to see elevated homocysteine because if those levels remain high in your blood, it can contribute to the development of blood clots, artery lining damage. And if you like already have developing atherosclerosis, it can make that worse and eventually lead to negative cardiovascular outcomes. High homocysteine levels have also in the literature that it's been associated with other chronic diseases and conditions like I don't know, like a lot of neurological ones, like Parkinson's, Alzheimer's, other types of dementia, that kind of thing. So if if you have concerns, family histories of any of that, you might want to get your homelysteine checked out.

Coach Carlie 23:53

Yeah. Again, shameless plug. Emily did this without I mean, she knows about the longevity label. But um, this is why we test this in our longevity lab, is for that exact reason. And I didn't know that about Parkinson's Alzheimer's and dementia. But when you s when you think through the biochemical process, yeah, why wouldn't that have something to do with not only cardiovascular risk, but also brain health? Or neurological, neurological health. Yeah. Right. Yeah, oh fascinating. So good. Okay. More nutrients. More nutrients. More nutrients. Okay. Yes. I would say definitely check out, yes.

SPEAKER_01 24:34

Check out our last podcast episode on bone health because we we talk a lot about vitamin D there and calcium. But just looking at vitamin D right now, we know that it's extremely common to be deficient in vitamin D, about a third of US adults, maybe even a little more. Uh most commonly, if you go get a vitamin

Vitamin D Testing And Dosing Nuance

SPEAKER_01 24:56

D test, they're going to measure the 25 hydroxyvitamin D form, which is the primary form that circulates in your blood. And they will measure that as opposed to like the active vitamin D in your body because it just has a longer half-life. So a little bit of nerding out right there. Yeah. Love it. Yeah. There's uh, as we we talked about this a little more in the last episode, but there aren't too many foods that naturally contain vitamin D. Um, it includes like fatty fish, beef liver, egg yolks, maybe a little bit in mushrooms. But if you struggle to get any of those foods in or don't live in an area where there's a ton of direct sunlight, or just don't go outside much to get that like natural vitamin D, you might want to look towards uh fortified foods and supplementation. And a lot of you might have seen a lot of milk and milk alternatives are fortified with vitamin D. There's also yogurt and breakfast cereal and orange juice for some reason. Those are all fortified with vitamin D as well.

Coach Carlie 26:02

Yeah, for sure. Usually most people, when they come to me, they're like, yeah, I take vitamin D. And I'm like, okay, well, what's the brand and how much? And then they're like, I don't know. Like, you know, this is it's I would relate it to being like, I have a pair of running shoes, and then I'm like, well, what brand are they and what size are they? And you're like, I don't know. I just bought, you know, like I just I was I just bought it off the shelf. Like, does it matter? Yes, it matters. Yes, it does matter very much so. So I think we're, I don't know. I just there's so many general recommendations, and I'm just not into general recommendations anymore. But you know, if you're at least getting like 400 IU, I think that they just boosted it to maybe 800 IU a day as like the general recommendations, but I just get so much more into precision nutrition than general recommendations.

SPEAKER_01 26:51

Right. Because like you mentioned earlier, like some people don't convert no vitamin D from the sun into the active form as well.

Coach Carlie 27:00

800 800 IU is gonna do them a hot bit of nothing. Yeah, I mean, seriously, like their vitamin D is just gonna be in the tank, and then we're gonna be like, I'm scratching our head, like, why didn't 800 IU work? And most folks are like, oh, your vitamin D needs a little boost. Go take a thousand IU a day or two thousand IU a day. And sometimes you need more than that. And sometimes you also need like a quick boost, and then we can go to a maintenance dose. Uh so again, know your metrics and know your brands, know your amounts. But if you don't care to know your brands and amounts, that's what we help with. We just tell you what to do, tell you what to take, and then it's up to you to and then try to work with you from a perspective of uh executing it. You know, because some people are like, I just I don't take pills very well. There are drops. There are like, listen, we have ways around these things. Right. We will make it as easy as possible so that you can be compliant. Because if you are not compliant, what's the point? Anyway, that was the end of my rant. Let's do that. Now we have calcium.

SPEAKER_01 28:03

Yes. Anyways, we we need the vitamin D and the calcium to ensure our bone health, among other things. So I think I mentioned earlier that in the C the the BMP or the CMP like basic labs, they usually measure the serum calcium. Yes. But usually if you're deficient, if you're not eating enough calcium, if that doesn't really show up in your blood level, because your

Calcium Myths And When To DEXA

SPEAKER_01 28:27

your body really tightly regulates your blood level of calcium. And the bad part is that if that ever drops and you're not eating enough calcium, your body's gonna take calcium from your bones, it's gonna break down some bone and release the calcium from there in order to maintain the blood levels. So your bone if you're not eating enough calcium, your bones might be slightly degrading and you don't even know.

Coach Carlie 28:53

Yeah.

SPEAKER_01 28:54

That's the danger. So if you want to have a better grasp of what your calcium status actually is, you're gonna want to go get a DEXA scan.

Coach Carlie 29:06

Yep. Emily, I was like holding my tongue. I was like, she's gonna say it in my favorite thing.

SPEAKER_01 29:11

And I did a DEXA scan. It's it's really, really good. It it really tells you um a lot of things, really. Your bone mineral density to see if you're eating enough calcium, but then also body composition things, uh, your fat and muscle mass, it will tell you that too.

Coach Carlie 29:29

Yeah. I have seen, I've seen both. I've seen the one that uh you can pay out of pocket for. Of course, it is a medical expense and you can use an HSA FSA card and you can, you know, submit it on your taxes, et cetera, et cetera. But there are also, if there is any concern of that and your doctor orders it, you can still get a DEXA scan, but you don't get the, you know, cool pictures of broken down, you just get your actual like bone density. You don't get the pictures of your, here's how much lean body mass you have, here's how much body fat you have, you don't get the literal pictures of your body and seeing what that all looks like, but it still will evaluate your bone health, which is good. I find it fascinating. This is such an interesting marker because depending on your calciums, that doesn't necessarily dictate whether you should be cons like having an additional supplement again, like zooming out and seeing what are you more regularly getting in terms of food sources in order to get that. It does, if you are not eating dairy, um, you have to be a little bit more intentional. If you're having non-dairy milks, that makes it a little bit easier. But if a glass of milk or plant milk is somewhere around 400 milligrams, I mean you're still needing to do that's several glass, that's several glasses a day outside of you know, smaller sources of you know, and we got some broccoli and maybe greens. But anyway, I just find that whole calcium process to be so fascinating. And your body's acidity is tied into that, and how much protein you're getting, and um, you know, protein and albumin, which are part of your uh CMP2, those are necessary to see what what does that whole process look like rather than oh my calcium is low, therefore I need to supplement. That is that is not the way you want to go about that particular lab. There's right.

SPEAKER_01 31:21

There's there's a lot a lot that goes into it.

Coach Carlie 31:24

Yes, for sure. So that's why I always recommend if you are gonna do direct-to-consumer labs, you need to have somebody supporting you interpreting this. This is literally why one of our main reasons why we created the longevity lab, which again, shameless plug, theendurance edge.com forward slash longevity. We go into genetics, we go into specific biomarkers, and then you get the support with interpretation trends so that you

Interpreting Trends And Getting Support

Coach Carlie 31:50

can understand your health and your needs, and then work alongside your additional healthcare team for making sure that you're staying on point. Cause again, so many different healthcare providers don't understand the demands and necessities of an athlete. And they're just like, Well, you're getting your exercise and you're healthy, so have a nice day. You're like, but something just seems off, and you know, uh, so you have to advocate for yourself a little bit more. Anyway, being able to have this process alongside your sport and your coach and being able to interpret all this so that you can make agile changes in your protocols that you are already implementing and making sure that they are fully directed at you. So uh we don't have a slide about longevity, but it doesn't matter. So um, you know, endurance edge.com forward slash longevity to learn more about that. Any Emily, anything else you want to say about labs?

SPEAKER_01 32:50

Um, I guess I have a little personal story. Oh, yes, please. Yeah, about the the calcium. So I was really, I was really lucky when I was growing up. I was maybe like 13 or 14. I was just getting like my annual physical for like my school sports or whatever. I was a I was a track and cross country girl. So my pediatrician was going over, she looked at my labs and they were she was like, okay, they're all normal. But then I like that she she asked me questions about like my diet too. Oh yeah. Just to like get a good picture of what was going on. And she kind she asked me, like, do you like, do you, do you eat usually eat any dairy? And I was like, no, because as a self-proclaimed picky eater, ever since I was a little kid, I've never liked milk, I've never liked cheese, I've never really liked yogurt very much. And she was like, but that and and even though my blood calcium was fine, she looked at me and was just like, you need to be eating more calcium. Or or like and and she would she like prescribed me a supplement like right there on the spot. Like I don't DEXA wasn't like a huge thing back then, but also she knew I was growing. I was I was 13 or 14. I was still like in puberty and trying to build like my I was growing like taller, my bones. She I think she knew that that just wasn't great for my bone health. So she she told me to get a cow to get on a calcium supplement, and I did for a while there.

Coach Carlie 34:15

So just just love it when we were talking about it last week, and you're like, huh, I probably should be thinking about that again.

SPEAKER_01 34:21

Yeah, I should probably get maybe get maybe I should get back on it because now I do eat more dairy.

Coach Carlie 34:28

It's so cheap. I love it. Uh wow.

SPEAKER_01 34:31

This is a like bonus internship, you know?

Coach Carlie 34:33

Yeah, it's bonus internship, right? Yeah. You get workouts, you get you get something like that. Yeah, totally. No. I I wish if I had my way, I wish more pediatricians, more orthopedists, more physical therapists, more folks were referring to dietitians when there is any sort of potential abnormality in that respect. Like, you know, you're an athlete and you're growing. Like, go see a sports dietitian.

SPEAKER_01 35:04

Yeah. That's what I should have done, honestly, after that visit.

Coach Carlie 35:08

Like, you have anemia, go see a sports dietitian. Like, physicians see, generally speaking, this has been been my experience, they see 28 patients a day. I see on a large load, I see seven at the most. And that's like a day when I I want to like cross my eyes and fall apart because we spend an hour, 30 minutes to an hour with folks, and they don't. They don't have the luxury of that. But that's okay, because then we can get into the nitty-gritty details of this is the supplement you should be on. This is these are the foods that you need to be eating. And if you don't eat those foods for, you know, because you are gluten-free or because you're lactose intolerant, or because you don't tolerate this protein or have this sensitivity or this allergy or whatever, that's the all the stuff that we do as dietitians. So, shameless plug for dietitians. I think we're the heroes of the healthcare industry that can spend deeper time working into these details of your health and wellness such that you can generally go to the doctor less. Right. I mean, that's kind of the and I'm all for physicals. I'm all for that and like regular checkups and all that kind of stuff. But doctors should not be doing nutrition, period. End of story. Yeah. Like so many people are oh, doctors need to know know more about nutrition. Absolutely not. I think that that is a horrible idea because we have spent the time going through that process to work as a collaborative team rather than continuing to send them to more education when they need to be practicing medicine and we can practice dietetics and we can do it better together. Yes.

SPEAKER_01 36:51

Anyway, I need a like I don't think you don't see people telling doctors to go study physical therapy.

Coach Carlie 36:57

Like that's because that's not their job. No, it's like it's not their job at all. And nutrition is not their job. It's just not. And yeah, it just it pains me a little bit when so many people are like, oh, this this doctor wrote this nutrition book.

SPEAKER_01 37:10

I'm like, where are the dietitians writing the nutrition books? So many doctors also will like prescribe you a supplement or something, and then you just don't get any type of follow-up or like continuity of care until like your next yearly physical. Yes. It's just with the dietitian, you get so much more regular, like, how's that been going? Yes.

Coach Carlie 37:32

Is there any like it is more accountability, more ongoing care, more opportunities to see what motivation is, you know, just working through the ups and downs of what happens, like, okay, so you're an athlete and you're injured. Does that mean your nutrition needs to change? Yes. It does. Absolutely. Does that need to be mean that we need to stay on top of your labs? Yes, absolutely. And staying on top of your labs as it relates to this podcast is the same great thing to monitor overreaching and monitor overtraining because overreaching happens before overtraining. Those are things that you can see from the inside out. Those are things that we can see from your dietary patterns. I mean, all of this is so important and cheaper. Like it's cheaper than going to the it's cheaper than going to the doctor. It is. Anyway, that is all that is all of my rant. And this is great, Emily. Nice work on putting this together.

SPEAKER_01 38:29

Thanks. It was a lot of fun and really jogged jogged my jogged my brain there.

Coach Carlie 38:34

That's right. I know you're gonna be so ready for this test. I'm excited for you. Thank you. All right, well, y'all, thanks for listening to our rants and thanks for listening to the Find Your Edge podcast. And if there are things that you want us to get deeper into, or whether it be a soapbox or some particular topic, uh let us know. Reach out, send us a DM on Instagram at the EnduranceEdge, or uh send us a contact us form on our webpage, theenduranceedge.com. Learn more about our longevity program, theenduranceedge.com forward slash longevity. And thanks for listening, and we will catch you next time.