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

Welcome to the Find Your Edge podcast. I'm your host, Chris Newport, founder, head coach, sports nutritionist, and exercise physiologist at The Endurance Edge. Our mission is to empower people to reach and sustain peak performance and health. So get ready to dive into all things training, nutrition, recovery, and more. We hope to give you detailed information and inspiring stories to help you be your best. Let's do it. 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, 'cause you know, you're our people. And I wanna 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 li— 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, 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. Mm-hmm. 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 gonna 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 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.

Mm-hmm.

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 wanna 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 dietetic 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.

We welcome all the rants. I, I, I love the high energy stuff.

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, I won't interrupt.

No, say something if you got something to say. But first of all, just wanted 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 sure they're, they're just like really basic labs for screening for really common conditions like—

Yes.

You know, cardiovascular disease, diabetes, anemia. So they just wanna make sure everything's good on all those ends.

Mm-hmm.

They're probably gonna have a complete blood count or a CBC. This is measuring 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.

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

You'll probably see the lipid panel. This will tell you your 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, they call it the good cholesterol. Mm-hmm. So you'll see all those. Something that's getting more common now is hemoglobin A1C. That's going to measure your overall blood glucose for the last like 2 to 3-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's important, but they don't always do it.

Yeah, because usually it's, you're not gonna get triggered with an iron panel unless you complain about some sort of excess fatigue.

Mm-hmm.

Sorry, you guys, you're athletes. At some point you're gonna get tired. Like, it's like, it's just part, part of the equation. But oftentimes that's not gonna be triggered unless your hemoglobin or hematocrit 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. 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've 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 like to add in ferritin to go along with. The iron panel.

For sure.

Mm-hmm. Yeah. So, but CBCs and, and CMPs are like, those 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 additional markers of heart health. So tell us, apolipoprotein B.

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

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 lipoproteins. 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. Mm-hmm.

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. Mm-hmm. While the ApoB test is really going to measure how many particles you have, how many LDL 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-bally type LDL—

Big dopey ones.

—that we were saying. Yes, the big dopey ones. It's going to 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. 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's high, let's put you on a statin. It's like, no, no, let's get more information. So better marker of predicting cardiovascular risk, right? Exactly.

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. Mm-hmm. 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. Yes.

You never know. And of course, you know, we're all nerds here and we test this because we can in our longevity lab cuz we just want a bigger picture of Cause 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 Ironman 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 statin. 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 part covered. Can you not send me this 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, and that sounded really rude to all physicians out there. I'm so sorry. I'm not, it's, our medical system is created more for, it's more of a sick model.

Mm-hmm.

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 2 years ago, 3 years ago, 10 years ago before I even had to know any of this stuff.

Like preventative rather than reactive.

Yes, 100%. Yes. Okay, what else do we want to know about? Let's get into this guy.

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

Yeah. Keep going. I love this human body. It's so awesome.

It's involved in so many different processes, like, but 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.

Right.

It's also kind of 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 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.

Yes. Yeah, that's, uh, for anybody in our longevity lab, that's what we test because again, we wanna better reflection of what's actually going on. And of course, working with athletes, um, I'm sorry, has anybody not cramped before? Like, 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 'em off, Emily, because Yeah.

This is so good. Also, I will for sure. You've got pumpkin seeds, black beans, quinoa, flax seeds, Brazil nuts, edamame, chia seeds. You're probably seeing a pattern here. It's a lot of nuts and beans and seeds. I do wanna mention on that list is also dark chocolate. So for, for those out there who like dark chocolate like me. I was gonna mention that first. Yeah, but it, for, for a lot of people it is hard to get a lot of these foods in like super regularly.

So, you know, leafy greens, I know they're not specifically on that list, but yeah.

But yeah, leafy greens for sure. Yeah.

Can be a harder sell. I get it. And some people just, you know, listen, if you have preferences, you have preferences, like no, right on you. 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 palates. Let's work around it. Like, it's—

Right.

If you're being a brat about it, it's one thing, but if you just— we just can't have it, it's another thing. So anyway, I think you have one more point on magnesium, and then—

Yeah, 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 wanna get your magnesium checked out. Yes. And just, just be sure you're on the right track.

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, all, I'm all for the workout for sure. Okay. What's our, what's our next lab marker?

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 B12 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. Mm-hmm.

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, mm-hmm, 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 wanna make sure that we're doing good things here. Also, there are genetic links to vitamin B12. Mm-hmm. 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?

Not yet. Yeah, let's, let's talk about it.

Okay, let's go.

So kind of like with the whole like magnesium thing, sometimes just measuring like your serum B12 is not gonna be the most accurate picture of your B12 status. There's a compound called methylmalonic acid.

Nice.

Or MMA.

Uh-huh.

Uh, cuz that's kind of a mouthful. It's, um, a, 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 a 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. 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, and the exercise plan.

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

Mm-hmm.

You might wanna consider supplementing.

Yes. And again, nothing wrong with you if you, if you're a vegetarian or vegan, like, mm-mm, 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 B12, homocysteine.

Homocysteine.

Yes.

Yes, it's very closely related to B12. So 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, as we all like to, you know, abbreviate everything.

Yeah.

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

Yeah.

Methionine.

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, 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.

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 wanna 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 5-methyltetrahydrofolate, uh, and goes through that whole process of, uh, 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— Mm-hmm. 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.

Efficiently.

Yeah, like do it efficiently. Do it eff— I'm all, I'm all for efficiency. Anyway, what, what else do you wanna say about home assisting?

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, but 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 homocysteine checked out.

Yeah. Again, shameless plug. Emily did this without, I mean, she knows about the Longevity Lab, Longevity Lab, 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, 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, or neurological, neurological health, right?

Yeah. Yeah, absolutely.

Oh, fascinating. So good. Okay. More nutrients. More nutrients.

More nutrients. Yes. I would say definitely check out— No, you're right. Yes. Mm-hmm. 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. Most commonly, if you go get a vitamin D test, they're going to measure the 25-hydroxy vitamin 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 that. There's, 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. 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 wanna look towards fortified foods and supplementation. And a lot of—

Mm-hmm.

You might have seen a lot of 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.

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 what 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 a day, 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.

Right. Because like you mentioned earlier, like some people don't convert vitamin D from the sun into the active form as well.

Yes. So 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 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 1,000 IU a day or 2,000 IU a day. And sometimes you, you need more than that. And sometimes you also need like a quick boost and then we can go to a, a maintenance dose. 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 is 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 executing it, you know, 'cause some people are like, "I don't take pills very well. There are drops." They're like, listen, we have ways around these things.

Right, right.

We will make it as easy as possible so that you can be compliant. 'Cause if you are not compliant, what's the point? Anyway, that was the end of my rant. Let's—

now we have calcium. Yes, anyways, we need the vitamin D and the calcium to, ensure our bone health among other things. Yeah. So I think I mentioned earlier that in the, 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, cuz your, 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. Mm-hmm. It's gonna break down some bone and release the calcium from there in order to maintain the blood levels. Mm-hmm. So your bone, if you're not eating enough calcium, your bones might be slightly degrading and you don't even know. Yeah, for sure. That's the danger. Yeah. So if you want to have a better grasp of what your calcium status actually is, you're gonna wanna go get a DEXA scan.

Yes.

That's gonna— yep.

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

Yeah. And I did DEXA scan.

Mm-hmm.

It's, it's really, really good. It, it really tells you a lot of things really, your bone mineral density to see if you're eating enough calcium.

Yeah.

But then also body composition things. Yes. Your fat and muscle mass. It will tell you that too.

Yeah, I have seen, I've seen both. I've seen the one that 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 'cause 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. Yeah. In order to get that, it does, if you are not eating dairy, 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 glasses a day outside of, you know, smaller sources of, you know, we got some broccoli and— Yeah.

Leafy 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, you know, protein and albumin, which are part of your CMP too, 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 wanna go about that particular lab. There's—

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

Yes, for sure. Mm-hmm. 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, theenduranceedge.com/longevity. We go into genetics, we go into specific biomarkers, and then you get the support with interpretation, trends so that you can understand your health and your needs and then work alongside your additional healthcare team for making sure that you're staying on point. Cuz again, so many different healthcare providers did, like, they 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.

Mm-hmm.

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, enduranceedge.com/longevity to learn more about that. Any, Emily, anything else you wanna say about labs?

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 asked me questions about like my diet too. Oh yeah, good. Just to like get a good picture of what was going on. And she asked me like, "Do you 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, 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.

No.

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 cal— to get on a calcium supplement. And I did for a while there. So just, just love it when—

I think Chris Newport was talking about it last week and you're like, huh, I probably should be thinking about that again.

Yeah, I should probably get, maybe, maybe I should get back on it because now I do eat more dairy. Emily, just let us know.

We'll, we'll put the order in for you. It's so cheap. I love it.

Wow. This is a like bonus internship, you know?

Yeah. It's bonus internship, right? You get, you get workouts, you get, you get Again, labs, supplements.

Yeah, totally.

No. 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.

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

Right? Like, you have anemia, go see a sports psych— like, physicians see, generally speaking, this has been my experience, they see 28 patients a day. I see, on a large load, I see 7 at the most. And that's like a day when I wanna 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.

And 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, dot, end of story.

Yeah.

Like so many people are—

I agree.

Oh, doctors need to 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.

Anyway. I need—

like, I don't think you— you don't see people telling doctors to go study physical therapy. Like, that's because that's not their job.

No, 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. 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—

No.

Like contin— continuity of care until like your next yearly physical.

Yes. Yeah.

It's just with the dietitian, you get so much more regular, like, how's that been going?

Yes.

Is there any, like, is this—

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.

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, is so important and cheaper, like cheaper than going to the test. 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.

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

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 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, let us know, reach out, send us a DM on Instagram @TheEnduranceEdge or send us a contact us form on our webpage, theenduranceedge.com. Learn more about our longevity program, theenduranceedge.com/longevity. And thanks for listening and we will catch you next time. Thanks for listening to the Find Your Edge podcast. If you like what you heard, don't forget to subscribe on your favorite podcast platform so you never miss an episode. And if you're interested in learning more about our endurance coaching, sports and wellness nutrition, metabolic and sweat testing, triathlon training team, or our triathlon training library, be sure to check us out at theenduranceedge.com. And don't forget to follow us on social media at The Endurance Edge. Thanks again, and we'll catch you next time.