A patient of mine recently asked about testing for Peter Attia’s “Four Horsemen of Chronic Disease” and I thought it was time to weigh in on this.
The 4 chronic diseases of aging aka the things that cause humans the most grief or end up taking us…
- heart disease
- cancer
- neurodegenerative conditions
- type 2 diabetes
Seeing patients in the same office for over a decade has granted me the ability to see the trajectory in how these conditions develop when certain health conditions are not addressed.
The last few years it’s become more clear how important it is for me to keep reinforcing the importance of prevention and screening.
Knowledge is power.
Power to make changes in your life to live the healthiest version of you possible.
Before I get to the tests Dr. Peter Attia recommends to evaluate for these for prevalent conditions of aging I want to tell you about my neighbor Ned (I changed his name for privacy).
He’s my blackberry picking buddy and Bryan’s new best friend (my Dad is very jealous).
Ned’s 82 and has smoked since his late teens.
He operated a small dairy farm 1/4 mile down the road from my house for most of his life.
When governmental changes required expensive upgrades to dairy farms he decided to become a postman in the bigger town just north of us.
Having had active jobs his entire life he has his aches and pains.
But what bothered him the most was the neuropathy in his feet.
At 82 he struggles to walk steady more than a few feet and any slight changes in terrain are tricky for him to navigate.
After a few months of watching him drink diet coke, eat white bread bologna sandwiches and have a variety of boxed sweet treats on his counter when I stopped by I asked…
…”how’s your blood sugar?”
His response – well I’m pre-diabetic but doc says watch my sugar intake and keep moving and I should be ok.
Um Ned…”did you doctor ask what you eat or even watch you move in the office?”
No he just comes in for a few minutes, listens to my heart and lungs tells me all sounds good.
Seriously?
Ned doesn’t even know his hemoglobin a1c (blood sugar on average number) or his fasting glucose.
You want to know these numbers to keep tabs on your health.
Likely it’s not “bad” enough to warrant conventional treatment.
Fasting blood sugar over 126 consistently is the red flag on diabetes.
Hemoglobin a1c’s over 6.0% require intervention.
Optimal a1c is 4.8-5.2% and optimal fasting blood sugar is under 90 (yes I’m more strict than conventional medicine because I intervene before it gets “bad”).
Ned has negative MRIs, X-rays and even nerve studies for any issues that would provoke neuropathy.
So what’s left to cause neuropathy?
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I could write a book on why smoking, diet soda, white bread, processed meat and boxed pastries are toxic to your nerves…
…but what’s not on the radar of many is the connection of pesticides like glyphosate to neuropathy.
He doesn’t filter his water – there are farms all around us using glyphosate and his son in law that farms his land surrounding him sprays.
He’s had these symptoms for over a decade.
Being me, I couldn’t let this go.
I gave him B12 lozenges to try for a month (Methyl-B12 helps the body detox via methylation processes + helps support nerve health).
Next I’ll have him try some Dihydroberberine (GD Aid from Biostack) to help balance blood sugar along with some milk thistle to see if we can detox the glyphosate and other chemicals from smoking a bit.
10 years with neuropathy has me really worried about the health of his nerves.
The Methyl-B12 is helping – gotta ease in with these older guys to get a win then they up for another thing.
Ned’s a lot like my Dad.
He’s teetering on having type 2 diabetes and now it’s turned into a neurodegenerative condition.
2 out of 4 of the top things taking humans to an early grave.
Ned loves to golf and enjoys his great grand kids – he’s not ready to go.
Golf is his true love and this is my leverage to make change.
The path to preventing all 4 of these chronic health conditions is based on your lifestyle…
- What you eat, drink and breathe – water and air quality are just as important as food.
- The habits you have (Ned’s smoking is linked to nervous system conditions too)
- How much you move during the day
- The way you manage your stress and thoughts
When someone has a passion for something it’s easier to help them make change.
It can be used as an anchor.
Using Ned’s desire to be a better golfer he and I will work on his neuropathy.
He agreed to doing acupuncture too – I can’t wait for to get started (he may feel differently).
Acupuncture between the toes, sounds super scary, yet it’s one of the best treatments for neuropathy.
And you can inject B12 between the toes to wake up the nerves too.
I haven’t told him about this “upgrade” to his acupuncture session yet.
Can’t let all my tricks out of the bag at once.
I’ll keep you all posted as to how Ned does going forward.
Till then let’s talk about how you can assess your own status on these 4 chronic diseases of aging…
- Lipoprotein (a) – Lp(a)
- LDL-P aka ApoB
- ALT liver enzyme
- ApoE Genotype
- Oral Glucose Tolerance Test
You can get 4 of 5 tests with Boston Heart Labs – cash pay via Rupa Health for $160.
The oral glucose tolerance test can be done using insurance or cash pay for a glucose test, which is approximately $30.
You want to do it on it’s own to not skew the rest of your lab results.
I’ll explain…
Because the Oral glucose tolerance test comes with a little caveat I do it my way.
To see how your body responds to sugar orally you have to drink a super sweet drink 2 hours before you have your labs drawn and then the glucose will be tested. (Note there’s a 1 hour test as well and sugar content varies from 50-100 grams based on test parameters ordered).
The OGTT test is typically done at OB-Gyn office for pregnant womenand they have to pick up Glucola, a dextrose (corn sugar) based drink with citric acid, food coloring and soybean oil and it comes in a variety of artificial flavors – which I’m not going to have anyone do.
To mimic this test you need an 8oz solution of: water + 75 grams of sugar (1/3 cup (67 grams + 2 teaspoons (8 grams of sugar) = 75 grams).
It’s nasty.
You could look at a commercial drink and add sugar to it as well.
If that doesn’t sound like fun to you – you’re not alone – there are other options to assess blood sugar.
I can get a pretty good idea of how well someone tolerates sugar by looking at fasting glucose, hemoglobin a1c and liver enzymes in a regular blood test that your doctor can order or you can self order via Labcorp On Demand.
Dr. Peter Attia’s 5 tests are not tests conventional docs are going to run during a general visit – you’ll have to ask or order on your own.
Don’t blame your regular docs – they are held to the parameters of the system.
I can’t stress this enough – the health system is based on disease management.
If you stay within it’s parameters you’ll be treated once you’re sick.
It’s easier to prevent than work to reverse conditions.
I’m guessing because you’re here you want to be proactive.
These markers above will give you a great idea of where you stand health wise.
I recommend pairing them with your annual labs your doc runs on you.
The more you know about your health the greater power you have to make change.
Making change can be tough…
… but if it’s the difference between freely walking the golf course or relying on the golf cart to get you to the T in life I’d choose freedom.
Stay tuned for tomorrow – I’m going to introduce you to a fella who’s super inspiring.
Questions on today’s testing? Hit reply – happy to guide you to resources and testing options.
Here’s to aging well,
Dr. J
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