About this Video

• Video Title: How to Use & Interpret Blood Tests for High Performance | Perform with Dr. Andy Galpin
• Channel: Perform with Dr. Andy Galpin
• Speakers: Dr. Andy Galpin
• Duration: 02:22:35

Introduction

This video discusses how to utilize blood tests to enhance athletic performance. Dr. Andy Galpin explains the pros and cons of blood testing, details how to select appropriate markers based on individual goals (e.g., bodybuilding vs. endurance), and guides viewers through interpreting results, considering both medical reference ranges and performance-specific contexts. He emphasizes understanding the difference between "sensitive" and "resilient" markers and utilizing patterns rather than focusing on individual values.

Key Takeaways

1. Blood testing is not mandatory for performance enhancement: While beneficial, success can be achieved without it.
2. Context is crucial for interpretation: Individual markers should be considered within the larger context of the athlete's training, nutrition, and overall health. Reference ranges provided by labs may not be optimal for high-performance athletes.
3. Identify "sensitive" vs. "resilient" markers: Sensitive markers are easily affected by acute changes (e.g., recent exercise, hydration), while resilient markers provide a more stable long-term picture (e.g., HbA1c).
4. Focus on patterns, not individual markers: Analyze groups of related markers (e.g., hydration, inflammation) to gain a more complete understanding of physiological status.
5. Prioritize lifestyle changes: Addressing major lifestyle factors (sleep, nutrition, stress management) yields greater improvements than focusing solely on specific supplementations.

The transcript is quite long, and Dr. Galpin often discusses multiple markers simultaneously or within the context of broader physiological processes. Therefore, providing a complete list of every mention of each marker with a detailed summary of his discussion for each would be extremely extensive.

However, I can offer a list of the individual markers he explicitly named and highlighted, along with a concise summary of his main points regarding each:

• Albumin: Considered the single best marker of overall health. Acts as an acute phase reactant, decreasing with inflammation and increasing with dehydration. Its interpretation requires understanding the individual's hydration and inflammation status. An optimal range is generally between 4.0 and 5.0 g/dL. Values below 4.0 are associated with serious health concerns. Values above 5.0 indicate chronic dehydration.

• Mean Corpuscular Volume (MCV): Represents the average size of red blood cells. Increases with B12 or B6 deficiencies but decreases with inflammation or iron deficiency. Blood testing for B12 is unreliable, so MCV interpretation requires considering other factors.

• Blood Urea Nitrogen (BUN): A product of protein degradation, indicating protein breakdown. Elevated BUN can result from various factors including dietary protein intake, catabolism, infections, dehydration, and kidney function. Interpretation requires considering multiple markers to understand the underlying cause.

• Total Protein: A marker relevant to protein turnover, especially when combined with other indicators like albumin and BUN.

• Globulin: Often calculated from total protein and albumin, also involved in assessing protein status.

• Blood Glucose (Fasting): Provides an acute measure of blood glucose levels.

• HbA1c: Reflects average blood glucose levels over the past 90 days (a chronic measure).

• C-peptide: Indicates a 24-hour insulin response.

• Glycomark: Reflects average blood glucose levels over 7-14 days.

• Fructosamine: Reflects average blood glucose levels over 14-21 days. Dr. Galpin suggests it's potentially a better indicator than HbA1c because it requires normal albumin levels for accurate interpretation.

• Iron: Crucial for oxygen transport. Deficiency is common among athletes, particularly female endurance athletes, due to factors such as menstruation, exercise-induced GI bleeding, and dietary intake. Multiple markers should be assessed to fully evaluate iron status (e.g., TIBC, transferrin saturation, ferritin, soluble transferrin receptors, hepcidin).

• Zinc: Often deficient in endurance athletes; important for various bodily functions (protein synthesis, cell function, glucose regulation, immunity).

• Chromium: Excreted more readily during exercise; involved in insulin regulation and metabolism.

• Magnesium: Depleted faster in exercisers; involved in many metabolic processes. Serum magnesium levels are not reliable indicators of total body magnesium status; questionnaires or more specialized tests are recommended.

• Sodium: Tightly regulated; most is excreted in urine. Dr. Galpin suggests that 5-6 grams per day is a likely sweet spot for exercisers.

• Potassium: Very tightly regulated; mostly found intracellularly. Most people consume less than needed, making supplementation potentially beneficial for those with high sweat rates.

• Vitamin B12: Its serum level is not a reliable indicator of intracellular levels, essential for energy production.

• Testosterone (Total and Free): Free testosterone is typically calculated, not directly measured, and the calculation method varies between labs.

• Sex Hormone-Binding Globulin (SHBG): Binds to testosterone; its level affects free testosterone calculations.

• Hemoglobin: A component of red blood cells; its level reflects oxygen-carrying capacity.

• Hematocrit: The percentage of blood volume composed of red blood cells; also reflects oxygen-carrying capacity.

• Creatinine: Increased levels are associated with muscle mass and creatine intake; does not always indicate kidney issues.

• Creatine Kinase (CK): A marker of muscle damage; significantly elevated after intense exercise, but extremely high levels may indicate rhabdomyolysis.

• Alanine Aminotransferase (ALT): Released from the liver; its level can be elevated by liver problems or increased muscle mass.

• Aspartate Aminotransferase (AST): Released from muscle; its level can be elevated by muscle damage or liver problems.

• Gamma-glutamyl transferase (GGT): Found in most cells; elevated levels, along with ALT, often suggest liver problems.

• C-Reactive Protein (CRP): An acute inflammatory marker.

• Erythrocyte Sedimentation Rate (ESR): A marker of longer-term inflammation (14-21 days).

• Homocysteine: Elevated levels are associated with increased risk of cardiovascular disease.

This list doesn't cover every mention, but it encompasses the markers Dr. Galpin focused on individually, explaining their significance in the context of athletic performance. Remember that his emphasis is always on using multiple markers together to create a broader picture.

Dr. Galpin highlights Vitamin B12 as a crucial nutrient for energy production and athletic performance. However, he emphasizes a critical point: blood serum levels of B12 are unreliable indicators of the body's actual B12 status.

Here's why, according to his explanation:

• Intracellular vs. Serum B12: The vast majority of the body's B12 is stored inside cells, not in the blood serum. Therefore, a blood test measuring serum B12 only reveals a tiny fraction of the total B12, making it a poor indicator of overall B12 sufficiency.

• Limited Diagnostic Value: A low serum B12 might indicate a severe, medically significant deficiency (in which case the individual would likely already be experiencing significant symptoms). However, normal or slightly low serum B12 does not guarantee adequate intracellular B12 for optimal function. Many athletes might be functionally deficient despite having seemingly normal blood test results.

• Alternative Assessment Methods: Dr. Galpin suggests that alternative methods of assessing B12 status, such as validated questionnaires, are often more accurate than relying solely on serum B12 levels. These questionnaires can better correlate with intracellular B12 status and functional deficiency.

In summary, while B12 is crucial for athletic performance, solely relying on a standard blood test for B12 is not recommended. Dr. Galpin advises using other assessment methods to determine B12 sufficiency and address potential deficiencies. He does not specifically recommend any particular alternative testing method beyond the questionnaires in this video.

Dr. Galpin's discussion of zinc centers around its importance for athletes, particularly endurance athletes, and the common issue of zinc deficiency in this population. Here's a summary of his key points:

• Prevalence of Deficiency: He notes that up to 25% of endurance athletes may have low or insufficient zinc status. This highlights the frequency of this deficiency in athletes.

• Multiple Bodily Functions: Zinc plays a vital role in various physiological processes relevant to athletic performance. These include:

  • Protein synthesis: Essential for building and repairing muscle tissue.
  • Cell function: Important for overall cellular health and function.
  • Glucose regulation: Impacts how the body uses glucose for energy.
  • Endocrine function: Affects hormone production and regulation.
  • Immunity: Supports the immune system's ability to fight off infections.
  • Wound healing: Essential for recovery from training-induced muscle damage.

• Importance of Adequate Intake: Due to its involvement in these crucial processes, maintaining adequate zinc levels is critical for optimal athletic performance and recovery. He doesn't give specific numbers on ideal zinc levels but strongly implies that simply reaching an "acceptable" level might be insufficient for highly trained individuals. The implication is that athletes need higher levels than the general population for optimal function.

In essence, Dr. Galpin emphasizes the frequent occurrence of zinc deficiency among endurance athletes and its broad impact on several key physiological functions. He strongly suggests that maintaining optimal zinc levels is vital for high-level athletic performance, urging listeners to pay close attention to their zinc status. He does not, however, provide specific recommendations for zinc supplementation or testing beyond stating its importance.

The transcript does not contain any mention of Vitamin C.

Regarding Vitamin D: Dr. Galpin doesn't discuss Vitamin D in depth as a primary topic. However, he does mention it briefly in the context of inflammation: He notes that vitamin D levels tend to decrease with increased inflammation. This is presented as one more piece of data to consider when evaluating the overall inflammatory status of an individual. He doesn't provide any specific recommendations or discuss optimal Vitamin D levels.

Here's a list of the chapters from the provided outline:

1. 00:00:00 Blood Testing, Albumin, MCV
2. 00:03:05 Sponsors: Eight Sleep & Vitality Blueprint
3. 00:05:55 Blood Testing for Performance
4. 00:09:24 Cons of Blood Work
5. 00:13:39 Pros of Blood Work
6. 00:19:30 Investigate: Blood Panels for General Health, CBC, CMP
7. 00:25:14 Blood Panels for Performance; Bodybuilding, Protein Turnover
8. 00:32:08 Sponsors: Momentous & LMNT
9. 00:35:21 Albumin, Hydration, Inflammation
10. 00:38:50 Endurance Training, Iron
11. 00:46:33 Essential Vitamins & Minerals: Zinc, Chromium, Magnesium, B12
12. 00:50:52 Sodium, Potassium
13. 00:56:48 Energy & Fatigue, Blood Glucose
14. 01:02:39 Sponsors: AG1 & Renaissance Periodization
15. 01:05:18 Tool: Getting Good Blood Data, 48-Hour Rule, Timing, Hydration
16. 01:12:55 Sensitive vs. Resilient Markers; Blood Test Consistency, Testosterone
17. 01:19:41 Interpret: References Ranges, Blood Glucose, Homocysteine
18. 01:28:44 Context & Interpretation, Strength vs. Endurance
19. 01:34:13 Sleep Apnea, Hemoglobin, Endurance Training
20. 01:37:33 Medical vs. Performance Blood Markers, Blood Volume, Creatinine
21. 01:46:18 ALT, AST, Athlete’s Paradox
22. 01:49:05 Optimal for What?, Context & Blood Markers
23. 01:56:35 Tool: Analytical, Diurnal & Biological Variability
24. 02:01:39 Patterns & Categories: Hydration, Inflammation
25. 02:09:01 Intervene: Big Solutions, Direct Markers vs. Systemic Solutions
26. 02:20:57 Zero-Cost Support, YouTube, Spotify & Apple Subscribe & Reviews, Sponsors, YouTube Feedback, Perform Newsletter, Social Media