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Соотношение кортизол/ДГЭА-С


A complex interaction between cortisol and dehydroepiandrosterone-sulphate (DHEA-S) is crucial in the stress system balance. In particular, significantly higher or lower cortisol/DHEA(S) ratios have been associated with depression1 and aggression2. In general, DHEA-S levels affect various body systems, as well as prevent aging (Chahal and Drake 2007). That is why the Cortisol DHEA ratio is a very informational indicator, which, along with other indicators calculated in Healsens, provides important information about human health. Thus, using the ratio of cortisol / DHEA-S, you can assess body responses to exercise or evaluate mental health. Another benefit is that you can check your cortisol and DHEA-S levels at home.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 March 2021.

How Cortisol and DHEA Sulfate Affect the Body

Let’s start by looking at how cortisol and DHEA-S affect overall health. Dehydroepiandrosterone (DHEA) and cortisol are produced in the adrenal glands and are both derived from pregnenolone. So, DHEA and DHEA-S production reaches its peak at the age of 20–30 and then declines progressively with age. When it comes to cortisol levels, while some studies show that cortisol increases with age3, others do not support this observation4. However, everyone agrees that the reduction in DHEA-S entails disruption of various physiological systems.

Stress Level

As mentioned above, DHEA and DHEA-S play a protective role during acute stress as an antagonist to the action of the stress hormone cortisol56. In turn, cortisol also helps to effectively manage stress. Let’s see how this happens.

About 15 minutes after a stressful situation, cortisol levels rise and remain elevated for several hours. This marks the onset of stage 1. During this stage, there are elevations in cortisol with no corresponding changes in DHEA. Subsequently, glucose is mobilized, non-essential organ systems are suppressed, and inflammation is reduced. All of these physiological responses collectively enable the body to effectively cope with stress.

However, in cases of chronic stress, this adaptive reaction can take a catastrophic turn: cortisol loses its ability to function normally. This transition ushers in stage 2. In this latter stage, the persistence of stress leads to a sustained peak in cortisol levels, matched by a corresponding elevation of DHEA.


It becomes increasingly challenging to maintain appropriate blood sugar levels, to allow for adequate rest, to achieve high-quality sleep, and to achieve a harmonious balance among other hormones. This signals the arrival of stage 3, wherein stress persists and becomes chronic. During this stage, cortisol levels decrease, while DHEA remains elevated. In the absence of timely intervention, prolonged adrenal hyperstimulation can result in adrenal exhaustion. This condition is eventually manifested by a decline in both cortisol and DHEA, a phase often denoted as adrenal exhaustion or stage 4. Ultimately, this process may culminate in adrenal failure.

Thus, the optimal ratio between salivary cortisol and DHEA is approximately 5:1 to 6:1, serving as an indicator of a normal state of adaptation to stress7.

When the body’s ability to maintain its normal stress adaptation is compromised, a process known as stress maladjustment can ensue. This phenomenon is now recognized as a chronic stress response, often identified by terms like pregnenolone steal, cortisol escape, or an elevated cortisol to DHEA ratio. The longer one remains in a state of chronic stress, the more pervasive its negative impact becomes on various aspects of physical well-being.

As a result, individuals grappling with depression or heightened anxiety levels (measured at 0.24 ± 0.03 in the healthy group compared to 0.41 ± 0.12 in the group of individuals with severe anxiety)8, along with those dealing with post-traumatic stress disorder, exhibit disruptions in the cortisol to DHEA ratio9. Nevertheless, it’s worth noting that certain studies have demonstrated the potential of DHEA treatment to mitigate the adverse health effects associated with stress.

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Musculoskeletal disorders

We have already mentioned that cortisol dysfunction entails disorders of the musculoskeletal system10. Thus, the higher the cortisol / DHEA-S ratio, the more serious the risk of this problem.

Moreover, multiple regression analysis showed that the independent risk factor for sarcopenia was a serum cortisol/DHEA-S ratio ≥ 0.211. Sarcopenia is a type of muscle loss that occurs with aging and/or immobility.

Immunity and Cortisol DHEA Ratio

In addition, an increase in the cortisol / DHEA-S ratio with age (Phillips et al. 2007) is associated with immune dysfunction and the risk of infection in the elderly due to the fact that DHEA-S enhances immunity. However, cortisol has an inverse immunosuppressive effect (Buford and Willoughby 2005). It is also worth adding that DHEA-S is known for its antioxidant properties12.

Metabolic Syndrome

Various studies have shown that both cortisol and DHEAS are related to metabolic syndrome13, and type 2 diabetes14. While high cortisol concentrations are associated with an increased risk of metabolic syndrome, high DHEA-S levels appear to be protective. By far, the strongest associations were observed for the cortisol / DHEA-S ratio. According to observations, the higher the coefficient, the greater the risk of metabolic syndrome. This ratio is also strongly associated with four of the five components of metabolic syndrome.

Alzheimer’s Disease

The cortisol / DHEA-S ratio may also be crucial in Alzheimer’s disease. For example, some studies have found a link between the cortisol / DHEA-C ratio and a decrease in hippocampal volume15. It is worth saying that a decrease in the volume of the hippocampus is one of the early diagnostic signs of Alzheimer’s disease.

This finding has been confirmed by other studies, observing the relationship between cortisol / DHEA-S and hippocampal atrophy (HA)1617. For example, such a direct relationship was observed in patients with Cushing’s syndrome18. Moreover, HC volume partially recovered following treatment-induced cortisol decrease. However, not all studies support this association within normal cortisol levels in healthy people19.

To sum up, the ratio of cortisol / DHEA sulfate can reflect:

  • psychological health (high level of anxiety, depression, etc.).
  • more favorable hormonal profile which implies higher levels of DHEA sulfate and a lower cortisol / DHEA-S ratio.
  • increased risk of sarcopenia.
  • increased risk of metabolic syndrome and type 2 diabetes.
  • mortality in general, which is strongly associated with the cortisol / DHEA-S ratio

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 March 2021.

Assessing Exercises

DHEA (Aldred et al. 2009; Cumming et al. 1986) and DHEA-S (Tremblay et al. 2004) have been shown to increase in response to active exercise. Measuring the ratio of cortisol to DHEA-S can help determine the intensity of physical activity. A higher level of cortisol and/or a lower level of DHEA-S may indicate significant physical stress. This can be valuable information for assessing whether the workout is sufficiently intense or if a lighter approach is needed to prevent overtraining. However, resistance training showed a stronger increase compared to endurance training (Tremblay et al. 2004). It’s also worth noting that trained and untrained people can cause different hormonal responses to exercise. So, untrained people experienced more significant increases in DHEA and cortisol levels2021. Such result was observed in both young people and people over 60 years old22.

How to define intensity of exercise?

For this purpose, the researchers used heart rate (HR) indicators. So the exercise was stopped as soon as the participants had reached 75% of their maximum HR. You can also determine maximum HR by the Tanaka formula:

208 − (age × 0.7)

So, for a 65-year-old person, the maximum heart rate will be 162 beats per minute. Consequently, 75% of this figure will be 121 bpm. Healthwise, muximum loads are not advisable. Therefore, it is recommended to use between 50% and 80% of the maximum.

Research has shown that 16 weeks of regular exercise decreased cortisol/ DHEA ratio by nearly 30%. In addition, athletes with the highest performance levels and the greatest amount of training had the lowest ratio. So,

Healthy Cortisol/DHEA-S Ratio

1 : 5 – 1 : 6

1:6 corresponds to 0.167 & 1:5 corresponds to 0.2

Adrenal/DHEA Restoration

High Adrenal/DHEA-S Ratio

Taking this into account, DHEA supplementation may be considered. Research confirms that it has a significant effect on the concentration of cortisol. For example, even a single morning dose of 200 mg DHEA can lower cortisol concentrations23. Moreover, in women, such a decrease was more pronounced.

An earlier study in healthy people came to the same result24. By the way, researchers also found that taking DHEA (300 mg) did not improve memory. However, supplementation is rational only in cases of decreased DHEA-S levels. In addition, it is important to monitor the sex steroid hormones as well as DHEA-S, because both deficiency and excess of DHEA can lead to negative symptoms.

In addition to DHEA supplements, your doctor may recommend pregnenolone25 and seriphos (phosphatidylserine)26. Seriphos was developed to aid in lowering cortisol. Besides, it contains key nutrients for stress resiliency. As for about pregnenolone, it is a steroid hormone. It plays a key role in the production of other steroid hormones, such as progesterone, DHEA, and estrogen.

Research also shows that fish oil supplements2728 and an Asian herbal medicine called ashwagandha both help to reduce cortisol levels29.

Calculated Cortisol/DHEA-S Ratio in Healsens App

Clinical Note

Improving adrenal function (augmenting DHEA and pregnenolone) can significantly enhance thyroid function, thereby reducing the amount of thyroid medication necessary. If this possibility is taken into account, it is suggested that any patient on thyroid should be closely monitored and lower dosages of pregnenolone and DHEA should be initially considered.

Low Adrenal/DHEA-S Ratio

So, as discussed in previous chapters, exercise has a positive effect on DHEA and cortisol levels. Besides, your doctor may recommend taking licorice extract. This is because licorice helps the adrenal glands prevent the breakdown of cortisol. In some cases, cortisol supplementation may be required.

Either with increased and decreased cortisol / DHEA-S ratio, an adrenal support program is recommended. So, try to balance your intake of protein, healthy fats, and carbohydrates. It will also be very beneficial to increase your vegetable intake to get the required amount of vitamins and minerals. To this end, foods high in vitamin C, B-5, B-6 and magnesium will assist in maintaining adrenal health.

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treatment for vitamin d deficiency


Vitamin D deficiency affects people of all ages. Last time we analyzed in detail how a deficiency of this vitamin affects our health. This time we will talk about natural and medical treatment for vitamin D deficiency.

This article was last reviewed by Svetlana Baloban, Healsens, on October 24, 2020. This article was last modified on 29 October 2020.

Let us start with how we define vitamin D deficiency.

In summary, a deficiency occurs when the serum 25-hydroxyvitamin D level is less than 20 ng/ml (50 nmol/L)12.

If your serum 25-hydroxyvitamin D level is between 20 and 30 ng/ml (50 to 75 nmol/liter), then we are talking about vitamin D insufficiency.

Values of less than 10 ng/ml refer to severe vitamin D deficiency. We will analyze the approach to treat this deficiency separately.

Treatment for vitamin D deficiency

Sunbathing, which we wrote about last time, is a great way of treating vitamin D deficiency. Another way to increase vitamin D levels in the body is food. In spite of the fact that food will not give you as much vitamin D as the sunlight, when combined with sun exposure it will work quite well. So make sure that your winter and summer diet includes oily fish (salmon, mackerel, tuna), egg yolks, cheese, liver, as well as enriched dairy and cereal-grain products.


In addition to sunbathing, those who have a lack of vitamin D (especially with critical numbers, when 25 (OH) D is less than 20 ng/ml) are advised to take vitamin D as a supplement. It should be said that an increase of 25(OH)D levels through dietary intake is quite individual.

How much vitamin D should I take if I’m deficient?

So, the amount of vitamin D needed to treat a deficiency depends largely on the degree of the deficiency and the underlying risk factors.

Initial supplementation with Vitamin D3 for 8 weeks, either 6,000 IU daily or 50,000 IU weekly, can be considered34. When the vitamin level exceeds 30 ng/ml, the daily maintenance dose will be 1000 to 2000 IU.

Higher-risk adults may require higher starting doses of vitamin D3. These people include African Americans, Hispanics, people with obesity, chronic illness, and taking certain medications. Typically, your doctor may prescribe 10,000 IU of vitamin per day. For such people, maintenance doses can range from 3000 to 6000 IU / day. So if you are at risk, it is better to discuss the treatment with your doctor. This is due to the fact that for some diseases, an individual approach to the dosage of vitamin D is required.

It is recommended that both D2 and D3 be taken with a diet containing fat to ensure maximum absorption.

Don’t be surprised if it will take you half a year or more to achieve the optimum levels of this vitamin. Furthermore, when the desired level of vitamin D is achieved, to sustain it you will need to take 1000-2000 ME a day and regularly control its level to prevent its overaccumulation in your body. Vitamin D3 (cholecalciferol) is considered to be more effective than vitamin D2 (ergocalciferol), although some recent studies have proven them equally effective.  

The dosage of vitamin D to correct severe vitamin D deficiency (<10 ng/mL)

Although not validated by clinical trials, a commonly applied strategy is to prescribe a “loading dose”. For example, 50,000 IU of vitamin D orally once weekly for 2-3 months, or 3 times weekly for 1 month5.

On the other hand, treatment regimen studies have shown that a minimum total dose of 600,000 IU was most effective in achieving vitamin D sufficiency6.

The study examined the following common treatment regimens, namely:

  • 50,000 IU of D2 once weekly for 4 weeks followed by 50,000 IU once monthly for 5 months;
  • D2 50,000 IU once monthly for 6 months;
  • D2 50,000 IU 3 times weekly for 6 weeks.

Regimens where vitamin D2 intake> 600,000 IU administered over an average of 60 +/- 40 days provided the best option without vitamin D toxicity.

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Maintenance Dose of Vitamin D

The recommended concentrations of 25(OH)D vary from 30 to 60 ng/mL. There is currently no evidence that values of 61-100 ng/mL provide health benefits. Along with taking preventing and maintaining doses, it is advisable to test your 25(OH)D in blood every 6-12 months. First of all, this recommendation is associated with a risk of falling below the levels of vitamin D. For example, some studies suggest that a maintenance dose of 2,000 IU of vitamin D may not be sufficient7.

It’s worth noting that in order to prevent vitamin D deficiency people aged 18-50 should receive 600-800 ME a day, those older than 50 – as much as 800-1000 ME a day. It is not recommended to prescribe more than 10,000 ME a day for a long period (more than 6 months) without medical supervision and control. Due to its lipophilicity, its accumulation in fat tissue may result in vitamin D becoming toxic.

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thyroid gland hormones


All hormones in our body must work in concert to maintain optimal health. Thyroid gland hormones play a major role in regulating this work. In today’s article, we will discuss which symptoms can tell us that not everything is in order with our thyroid hormones. We will also take a closer look at the three ways to check the functioning of the thyroid gland.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 17 February 2020.

If we look into history, we will see that thyroidology itself (the study of the thyroid gland) is a relatively new field of endocrinology. In spite of this fact, however, as early as in 1600 BC Chinese writers described the treatment of thyroid goiter (an enlarged thyroid gland) with burnt seaweed1. However, the goiter itself was not specifically associated with the thyroid gland. It was only in 1656 that Thomas Wharton first gave the thyroid the name that is still in use today.

How thyroid gland hormones affect health

Thyroid hormone is the main regulator of hormonal levels. Many people do not realize that they have a dysfunction of the thyroid gland even though it is a disorder, every tenth2 of which, leads to many adverse health changes.

In this case we are talking about already diagnosed problems. However, according to the American Thyroid Association, up to 60 percent of people with thyroid disease go undiagnosed3. And an undiagnosed illness can put patients at risk of getting some serious illnesses. How do thyroid hormones affect our body?



Thyroid gland hormones have a permissive effect on catecholamines. Catecholamines are a group of similar hormones produced by the adrenal medulla. Those, in turn, increase the expression of beta-receptors to increase heart rate, stroke volume, cardiac output, and contractility4. Often, people with hypothyroidism have very high cholesterol levels (350 and higher), and a bunch of other risk factors leading to a cardiovascular disease5.


Thyroid hormones are responsible for thermoregulation, which is why people with reduced thyroid function (hypothyroidism) often complain that they are constantly cold. This happens due to increased available energy in the body, as well as increased appetite, heart rate, and the amount of oxygen delivered to various parts of the body.


These hormones also help control the basal metabolic rate (the rate at which calories are burned). So fatigue and excess weight are also signs of hypothyroidism. On average, an underactive thyroid gland can add 5 to 15 kg of weight. But most of that extra weight will come from water and salt. In addition, decreased thyroid function can cause constipation6, memory problems, and lethargy.

An overactive thyroid gland (hyperthyroidism) is characterized by the opposite signs: having difficulty gaining weight, feeling hot, having frequent bowel movements, feeling nervous, and having a rapid heart rate. Other functions controlled by thyroid hormones include metabolism of fats, proteins and carbohydrates, as well as protein synthesis.

Relation to other hormones

There is also an interrealtion between thyroid function and control over other hormone levels. So, deviation of the thyroid hormone level from the norm can adversely affect the work of the adrenal glands. For instance, сertain human autoimmune conditions can destroy both the thyroid gland and adrenal cortex resulting in combined hormone deficiencies7. Moreover, dysfunction of the thyroid gland negatively affects the levels of sex hormones. Hyper- and hypothyroid men have increased rates of sexual dysfunction, including erectile dysfunction (ED). But the good news is that treatment of thyroid disorder at least partially reverses sexual dysfunction8. Thyroid hormone also affects fertility, ovulation, and menstruation9.

What hormones does the thyroid gland produce? In the following, we will discuss three tests for testing thyroid function – thyroid stimulating hormone (TSH), free T3, and free T4. You will probably want to make these tests part of your early diagnosis program and get them done regularly.

Thyroid stimulating hormone (TSH)

Thyroid stimulating hormone is a hormone that stimulates the thyroid gland. It is also known as TSH and is a glycoprotein hormone produced by the anterior pituitary gland. It is the main stimulus for the production of thyroid hormones. The TSH screening test is the first line test for suspected thyroid disease.

According to the American Thyroid Association, TSH levels are typically between 0.4 and 4.0 milliunits per liter (mU / L). However, these ranges will vary among laboratories and the upper limit can be raised from 4 to 5. If your level is higher than this, you are most likely to have an underactive thyroid gland. However, some studies show that this range should actually lie within 0.45–2.5 mIU / L. This is because TSH below the upper limit of the normal reference range poses an additional risk of progression to overt hypothyroidism over time1011.

So, high TSH levels indicate that your thyroid gland is not producing enough thyroid hormones. This condition is called hypothyroidism, which we wrote about above. Low TSH levels, on the other hand, may mean that your thyroid is producing too much hormone, the condition is called hyperthyroidism. Hyperthyroidism can be caused by Graves’ disease. This is a condition when your body’s immune system attacks the thyroid gland. It can also be a result of too much iodine in your body.

T3 (triiodothyronine) and T4 (thyroxine)

T3 (triiodothyronine) and T4 (thyroxine) are the two key thyroid hormones that are produced by the thyroid gland. The main product of thyroid secretion is T4, while T3 is secreted only in small amounts12. However, the activity of T3 is three to four times higher than that of T4. Nonetheless, both hormones play a vital role. Both T3 and T4 contain iodine. And it is iodine that is one of the main building blocks of both hormones. So let’s talk about tests that help measure the content of these hormones in the body.

Triiodothyronine (T3)

So, T3 thyroid hormone is the most active of the two main hormones. Normal levels of total T3 (free and bound) in the blood are between 75 and 195 ng / dL. The normal level of free T3 in the blood is 0.2-0.5 ng / dL.

If your results show high levels of total T3 or free T3, this could mean that you have hyperthyroidism. High T3 levels can lead to unpleasant symptoms such as rapid heart beat, insomnia and anxiety. High T3 levels also can harm the heart and the bones.

Low T3 levels may mean you have hypothyroidism. Typically, the T3 test results are often compared to the T4 and TSH test results. This helps to more accurately diagnose thyroid disease and understand whether the disease is primary or secondary. Primary hypothyroidism is most common; it is associated with thyroid disease and high thyroid-stimulating hormone (TSH) levels. Secondary hypothyroidism is less common; it is associated with a disease of the pituitary gland or hypothalamus. The TSH level will be low.

So, if we talk about the role of triiodothyronine, then it regulates the rate of oxygen consumption by tissues, and also stimulates protein synthesis, gluconeogenesis and glycogenolysis (which leads to an increase in the concentration of glucose in the blood). It is also responsible for lipolysis and intestinal motor function. In addition, triiodothyronine enhances catabolism and excretion of cholesterol with bile, promotes the synthesis of vitamin A and the absorption of vitamin B12 in the intestine, bone growth, and the production of sex hormones.

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Thyroxine (T4)

A normal total T4 level in adults ranges from 5.0 to 12.0μg/dL. As for free T4, the normal range in adults is 0.8 to 1.8 nanograms per deciliter (ng / dL) or 12 to 30 pmol / L. In general, high thyroxine T4 levels (as well as total T4, free T4, or free T4 index) may indicate an overactive thyroid gland (hyperthyroidism). A low level may indicate an underactive thyroid gland (hypothyroidism).

Just like in situation with T3, doctors don’t only look at your T4 level, but also at your TSH level to diagnose hypothyroidism. So, if TSH> 4.0 / mU/L, and the T4 level is low, then this is hypothyroidism. However, if your TSH is higher than  4.0 mU / L and your T4 level is normal, then your doctor will most likely suggest testing your serum thyroid peroxidase antibodies (anti-TPO). If these antibodies are present, it may indicate an autoimmune thyroid disorder, which is a risk factor for hypothyroidism13. In this case you will be advised to take a TSH test at least once a year.

Higher T4 or lower TSH levels are known to be associated with an increased risk of dementia14.

In addition to the two hormones described above, there is another hormone produced by the thyroid gland. It is called calcitonin. Calcitonin is produced by C cells and is involved in calcium and bone metabolism.

The role of the pituitary gland

In conclusion, we’d like to say a few words on how the pituitary gland affects the production of thyroid hormones. Sometimes our body needs more thyroid hormones, and sometimes fewer. For example, when we grow up, feel cold or are pregnant, the thyroid gland, to produce the right amount of hormones, needs help of another gland: the pituitary gland. The pituitary gland tells the thyroid gland whether it needs to release more hormones or fewer hormones into the bloodstream. Also, a certain amount of thyroid hormones are needed to transport proteins in the blood. If the body needs more hormones, T3 and T4 can be released from blood proteins and do their job.

👉Thus, there is no uniform recommendation on the need for screening for thyroid hormones!15

☝️For example, the American Thyroid Association recommends TSH screening for all adults over 35, with retests every 5 years. However, AACE recommends routine screening for TSH in elderly patients regardless of their age. But the USPSTF still discourages routine thyroid screening in non-pregnant adults.

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vitamin a immune system


Vitamins are essential constituents of our diet that have been known to influence the immune system. But which vitamins have proven effective to help our immune system? Is a healthy diet enough? All these questions are constantly raised and become especially burning during epidemics. In turn, many studies test hypotheses and publish the results, sometimes breaking quite common myths. This time, to further expand on the topic of immunity health, we will review how vitamin A affects the immune system. We will also answer the question of how to check a deficiency / excess of this vitamin.

This article was last reviewed by Svetlana Baloban, Healsens, on February 23, 2020. This article was last modified on 22 February 2020.

To begin with, we note that vitamins cannot be sufficiently synthesized by our body and must come to us with food. So Albert Szent-Gyorgyi, who won Nobel Prize in Physiology or Medicine, said that “Vitamins and their metabolites are essential for a large number of physiological processes”. And that’s true. Vitamins and their metabolites are essential for a large number of physiological processes. They play an important role in the immune system, extending to both innate and adaptive immune responses

Vitamin A Helps Immune System


Many people know that vitamin A is crucial for maintaining vision. And, of course, who has not heard that it is widely used in cosmetics?! Vitamin A turned out to be the first vitamin approved by the Food and Drug Administration as an anti-wrinkle agent.1. Thus, it confirmed its ability to change the appearance of the skin surface and has anti-aging effects.

However, its functions do not end there. So, it is crucial for promoting growth and development and protecting epithelium and mucus. Did you know that it’s also called an anti-inflammation vitamin? It has to do with its critical role in enhancing immune function. For this function, vitamin A should be referred to as the vitamin that helps our immune system.

In turn, vitamin A deficiency impairs innate immunity by impeding the regeneration of mucosal barriers damaged by infection. It’s not just that our innate immunity suffers, but vitamin A is also required for adaptive immunity2. In severe cases, the immune system is so weak that it cannot even cope with a common cold.

There are several reasons why vitamin A deficiency may develop. First of all, nutritional deficiencies can affect the lack of this vitamin. So, we obtain vitamin A through diet in two forms. Retinol and retinyl ester come from animal sources such as meat, dairy products, and fish. Provitamin A (beta-carotenoid) is derived from colorful fruits and vegetables. Insufficient intake of the vitamin with food may result in its deficiency.

Second, vitamin deficiency is associated with certain diseases, such as liver disorder. Moreover, infectious diseases transiently depress serum retinol concentrations. Zinc deficiency can also impair the absorption, transportation and metabolism of vitamin A.

Let’s see how often vitamin A deficiency occurs in people?

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Vitamin A Deficiency and Its Impact on the Immune System

Vitamin A deficiency (VAD) is the single most important cause of childhood blindness in developing countries. Dietary surveys indicate that many US adults are not meeting dietary requirements for vitamin A3. According to their results, 51% of adults fall short of the Estimated Average Requirement.

But what about the situation in other countries? ? In 2018, a paper was published about vitamin A intake in China among 12,246 adults aged 18 to 64 years old. Approximately 87% of adults didn’t consume enough vitamin A4. Remarkably, retinol intake was significantly higher in younger adults compared to older adults, and in males compared to females.

Therefore, understanding the symptoms of vitamin A deficiency can be very helpful. So, classic symptoms include problems such as dry eyes and night blindness. Although eye problems are the most well-known issues related to vitamin A deficiency, this symptom may not be observed. Therefore, we consider other symptoms.

Dry skin also is suggestive of its deficiency but can be due to other causes. Moreover, poor wound healing, as well as acne, may indicate a problem of vitamin A.

To diagnose vitamin A deficiency, a serum vitamin A/retinol analysis is used. This lab test will be useful if levels are under 28 μg/dL. In this case, it will indicate an acute shortage. However, this analysis is not suitable if deficiency is mild. This is due to the fact that serum retinol concentrations don’t begin to decline in healthy individuals until liver reserves of vitamin A are dangerously low.

How is vitamin A deficiency treated and prevented?

In order to prevent vitamin A deficiency, it will be enough to include foods rich in vitamin A into your diet. Concentrations of preformed vitamin A are highest in liver and fish oils. Other sources of preformed vitamin A include such foods as:

  • Spinach, kale, collards, brocolli and other leafy green vegetables
  • Beta-carotene-rich fruits such as apricots, mango, and peaches, and highly-coloured vegetables such as carrots, squash, sweet potato
  • Milk or cereals enriched in vitamin A
  • Liver
  • Egg yolks
  • Fish liver oils

The recommended daily allowance (RDA) is 900 mcg and 700 mcg per day for men and women. So, one medium-sized raw carrot, weighing 61 g, contains 509 mcg RAE of vitamin A.

To talk about vitamin A deficiency, it treated with vitamin A palmitate oil. For such cases, a dosage of 60,000 IU is taken orally for 2 days. Then the dosage reduced to 4500 IU orally per day.

An alternative dosing is:

  • 50,000 IU for infants below 6 months of age
  • 100,000 IU for infants 6–12 months of age
  • 200,000 IU for 12 months through adulthood

Hypervitaminosis A or Vitamin A Toxicity

Vitamin A is fat-soluble. Therefore the body is able to accumulate it, mainly in the liver. Accordingly, its excessive consumption can lead to its excess, which is toxic (hypervitaminosis A). But do not worry that a regular diet can lead to such results. As already mentioned, a study of dietary preferences came to exactly opposite conclusion.

Nevertheless, excessive consumption of foods rich in vitamin A has been observed. For example, the authors of “Carrot man” tell a story of a 48-year-old male. The man complained to his primary care physician of abdominal discomfort and yellow/orange skin discoloration. It turned out that he ate 6-7 lb of carrots per week which lead to health problems. However, once he abandoned carrot diet, everything returned to norm within 1 month5. As for severe poisoning cases, it is known that researchers in the Arctic in the XIX died after they ate a polar bear liver rich in vitamin A.

To summarize, under normal conditions, an excess of vitamin A is not related to nutrition. As a rule, an excess is usually associated with the consumption of excessive amounts of vitamin A from supplements.

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Detecting any kind of blood vessel problems before they lead to a catastrophe is life-saving. This is what we call early detection – the primary purpose of creating our platform. It was estimated by WHO that 17,9 million people died from cardio-vascular cases in 2016, which accounts for 32% of all global deaths1. Of these deaths, 85% resulted from either a heart attack or a stroke. In more than half of these cases, diseases were clinically silent. Till the very day when heart attacks took away their lives they didn’t feel any pain in their chest, nor any heartbeat disorder, which could point to any heart problems. That is why today we will talk about monitoring and sustaining healthy lipid levels and the importance of doing so for healthy living. So, a lipid panel blood test helps to assess the four major risk factors for cardiovascular diseases: total cholesterol levels, LDL cholesterol, HDL cholesterol and triglycerides.

This article was last reviewed by Svetlana Baloban, Healsens, on January 4, 2022. This article was last modified on 9 May 2023.

Many tragedies can be avoided due to the existence of a few simple, safe and inexpensive lab tests. These tests are able to detect a cardiovascular disease long before it results in a heart attack or a blood stroke. Detect it when it is possible to prevent almost any disorders. Luckily, for taking the recommended medical tests neither big money nor doctors’ prescriptions or permissions are needed.

So, an effective program of early diagnosing is based on a combination of several blood tests, namely homocysteine levels and CRP lab tests, and radiological methods, including calcium score and coronary ultrasonography, which might be added into your Preventive Medicine health checklist.

The American Heart Association recommends that everyone over age 20 get a lipid panel blood test so you know what your levels are and can do something about them if you need to. The National Cholesterol Education Program (NCEP) recommends that adults have their cholesterol checked every 4-6 years2.

Cholesterol Definition

Cholesterol is the form of fat we need to make outer membranes of our body cells stable. However, doctors have noticed for many years that people with high cholesterol levels suffer from cardiovascular diseases more often.


In fact, they have discovered recently that different forms of cholesterol (“good” and “bad” cholesterol) also play a role. High levels of total cholesterol, high levels of bad cholesterol or low levels of good cholesterol adversely affect the cardiovascular system. For example, LDL or “bad” cholesterol can stick to blood vessel walls. For many years it can be a major factor in artery obstruction and more specifically in hardening of arteries, the process known as atherosclerosis.

Narrow arteries of your heart can get spontaneous blood clots, causing heart attacks and strokes. And high levels of triglycerides in the blood are associated with higher risks of cardiovascular diseases (CVD), even though the exact reason for this is not clear.

Preventive guidelines for a lipid panel blood test among young adults differ, but experts agree on the need to screen young adults who have other risk factors for coronary heart disease: obesity, smoking, high blood pressure, diabetes, and family history.

Less than half of young adults who have these risk factors don’t get cholesterol screening even though up to a quarter of them have elevated cholesterol3.

Lipid Panel Results

Total Cholesterol Levels

Following the recommendations by the US National Cholesterol Education Program (NCEP) total cholesterol concentration should fall below 200 mg/dL (5.17 mmol/L). 200 – 239 range will be the upper limit, any numbers higher than 240 indicate a risk of cardio-vascular diseases twice as high as that indicated by numbers lower than 200. As a general rule, the higher the cholesterol levels, the higher the risk of cardiovascular disease, although cholesterol is not the only risk factor. However, some new scientific evidence suggests that the optimum total cholesterol should lie within the range of 160 to 180 mg/dL (4.6 mmol/L). This data is supported by some investigation, showing that lowering total cholesterol to these indexes may decrease the risk of cardiovascular cases. If your cardiac computed tomography (CT) or carotid artery ultrasound detected problems, you need to bring your total cholesterol down to these optimum levels.


More than 102 million American Adults (20 years or older) have total cholesterol levels at or above 200 mg/dL, which is above healthy levels. More than 35 million of these people have levels of 240 mg/dL or higher, which puts them at high risk for heart disease.

Low-density lipoprotein cholesterol or LDL Lab Test Results

LDL stands for lowdensity lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries. An extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries; this is a condition called atherosclerosis.

To define your own optimum LDL cholesterol you have to consider all risk factors from those listed below:

Serious risk factors:

If you found to have one or more serious risk factors, you are in the group of high risk and it’s time to come to grips with the fact that you have to lower your LDL-C levels.

NCEP recommends the maximum level of LDL cholesterol for this high-risk group is 100 mg/dL (2.58 mmol/L).

Key risk factors:

  • Age: older than 45 for men, and older than 55 for women
  • Cigarette smoking
  • Cases of premature heart disease or cardiovascular disease cases among close relatives (parents, siblings, or children) (older than 55 for men or older than 65 for women)
  • High arterial blood pressure (140/90 or higher, or if drugs are taken to normalize blood pressure)
  • HDL levels below 40
  • Calcium score higher than 25 procentile (this is an extra recommendation – it is not listed in NCEP).

If you have one or less key risk factors, then according to NCEP, your LDL levels must be lower than 160 mg/dL (4.14 mmol/L). At the same time if you have 2 or more risk factors, then you should keep your LDL levels below 130, and below 100 would be even better. People who belong to the high-risk group of getting a heart attack or a stroke recommended keeping LDL levels below 100. Some recent studies show (indicate) positive results when the numbers are kept under 70.

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High-density lipoprotein cholesterol or HDL Lab Test results

HDL (high-density lipoprotein), or “good” cholesterol, absorbs cholesterol and carries it back to the liver. The liver then flushes it from the body. But the antiatherogenic properties of HDL cholesterol do not end there. Thus, HDL cholesterol has antioxidant properties and shows an anti-inflammatory effect4. In addition, HDL has the ability to increase glucose uptake by skeletal muscle and stimulate insulin secretion by pancreatic beta cells5.

So, high levels of HDL cholesterol can lower your risk for heart disease and stroke. HDL level below 40 mg/dL (or 1.03 mmol/L) is the main risk factor of cardiovascular disease. If HDL level is higher than 60 mg/dL, cholesterol of this type performs barrier function.

HDL Results Tracking in Healsens App

At the same time, HDL levels below 40mg /dL among men and below 50 mg/dL among women are the symptom of (indicate, point to) metabolic syndrome, which in its turn, is also a major risk factor for cardiovascular disease.

Note that there are several reasons for low HDL cholesterol. Thus, type 2 diabetes is commonly accompanied by a low level of high-density lipoprotein cholesterol. This contributes to the increased cardiovascular risk associated with this condition. In addition, overweight, obesity, smoking, elevated triglycerides (TG), and physical deficiency are among the main factors of low HDL.

As for physical activity, then a recent meta-analysis has provided some insights into how much exercise is required6. So, an increase in HDL concentration was apparent only in people who exercised for at least 120 minutes each week.

Triglycerides Lab Test results

Triglycerides are the main criteria indicating levels of fat in the blood. The high content of triglycerides combined with low HDL levels is considered a characteristic of metabolic syndrome. Often high levels of triglycerides result from high consumption of sugar-containing products and high glycemic index. The general population’s ideal triglyceride level is less than 150 mg/dL or less than 1.7 mmol/L7 by FDA. Anything over 500 mg/dL is considered very high. At this level, there is a high risk of developing pancreatitis (inflammation of the pancreas). This condition can lead to permanent tissue damage. It is usually accompanied by abdominal pain, which can be very severe.

Guidelines for triglyceride levels in healthy adults are:

  • Normal: under 150 mg/dL
  • Borderline high: 150-199 mg/dL
  • High: 200-499 mg/dL
  • Very high: 500 mg/dL or higher

HDL and triglycerides are metabolically connected and are often inversely related: As triglycerides go up, HDL goes down — and vice versa. But that isn’t always so. People can have “isolated” high triglycerides without low HDL levels, and research is now showing that high triglycerides are an independent risk factor for cardiovascular disease, no matter what the HDL is8.

Lipid Panel Blood Test With Additional  Additional Classes

Some labs provide advanced cardiovascular and lipid panel blood test that go beyond typical cholesterol testing to uncover risk factors for early heart disease.

As you can see there are two new components are added to this test: Lp(a) and ApoB. Lp(a) (also called Lipoprotein(a) is a lipoprotein subclass. Genetic studies and numerous epidemiologic studies have identified Lp(a) as a risk factor for atherosclerotic diseases such as coronary heart disease and stroke. It is similar to low – density lipoprotein (LDL, the “bad” cholesterol) in that it contains a single apolipoprotein B protein along with cholesterol and other lipids. This test measures the amount of Lp(a) in the blood to help evaluate a person’s risk of developing cardiovascular disease (CVD).

ApoB and ApoA-I are the two major apolipoproteins involved in lipid transport and in the processes causing atherosclerosis and its complications. ApoB is the main protein found in the low-density lipoproteins (LDL). Apo B increases this clogging, so your Apo B level may be a better indicator of cardiovascular risk than even LDL cholesterol.

Using the VAP Test tas Lipid Panel Blood Test

So, VAP test or Vertical Auto Profile provides even more detailed information about lipid levels as opposed to conventional examination, since this lab test directly assesses LDL levels. Traditional tests on the other hand measure only total cholesterol, HDL and triglyceride levels, and then use them to calculate LDL levels using these numbers. However, this is not the only advantage of VAP test, as this test gives additional information about the size and a current number of LDL particles, as well as tells about the number of less dangerous, large and spongy A-particles, and more dangerous small and dense LDL B-particles present in your body. Light and spongy A-particles easily push off the artery walls. On the other hand, small and dense B-particles are destructive and easily penetrate artery walls. An elevated number of small B-particles is often found among patients suffering from diabetes or metabolic syndrome.    

Components of Lipid Panel Blood Test

  • HDL2 and HDL3  subfractions
  • Pattern A or B LDL
  • VLDL cholesterol
  • Non-HDL
  • apoB100-calc
  • LDL-R (real)
  • Lp (a)
  • IDL
  • Remnant lipoprotein

Cholesterol VLDL

Very low-density lipoprotein (VLDL) cholesterol is a type of fat in the blood. It is considered one of the “bad” forms of cholesterol, along with LDL cholesterol and triglycerides. This is because high levels of cholesterol can clog arteries and lead to a heart attack.

Normal VLDL cholesterol levels range from 2 to 30 mg/dL (0.1 to 1.7 mmol/L).

Because VAP measures additional lipoprotein classes, such as Lp(a), IDL, and subclasses of HDL, LDL, and VLDL, it can identify patients at high risk for coronary heart disease who cannot be identified using the standard lipid panel blood test. In addition, the VAP method is compliant with the National Cholesterol Education Program’s Adult Treatment Panel III guidelines.

Thus, if your lipid levels don’t meet the norms, you should take this test more often, say every four or six months, until you achieve the results you wish.

What to do if your lipid profile is outside the healthy range?

Self-treatment with a balanced diet and regular physical activity can help lower the levels of lipoproteins. If your lipid profile needs correction, consider the following recommendations to reduce the risk of cardiovascular diseases:

  • Quit smoking if you smoke. Smoking is a major risk factor for cardiovascular diseases. The risk of coronary heart disease, stroke, heart failure, or peripheral vascular disease is two to six times higher in smokers compared to non-smokers.
  • Follow dietary recommendations to reduce the risk of cardiovascular diseases, such as the “five-wheel” approach. The most important nutrients influencing this risk are saturated fatty acids (which increase LDL cholesterol levels compared to unsaturated fatty acids), salt (which raises blood pressure), and fiber (which reduces the risk of cardiovascular diseases). Vegetables, fruits, fish, and unsalted nuts also lower the risk of cardiovascular diseases.
  • Allocate at least 150 minutes per week to moderate-intensity exercises such as walking or cycling. Integrate physical activity into your daily life. Increasing the duration, frequency, and/or intensity of exercises will provide additional health benefits.
  • Include strength and bone-strengthening workouts at least twice a week, especially for older adults.
  • Avoid excessive sitting (more than eight hours a day).
  • Maintain a harmonious psycho-emotional state.

Regarding medications, your doctor may prescribe statins such as simvastatin, lovastatin, atorvastatin, and rosuvastatin. These are well-studied drugs that not only lower LDL cholesterol levels but also have a positive impact on blood vessels.

Your doctor will strive to achieve specific cholesterol levels, typically LDL cholesterol levels below 2.6 mmol/L. Additionally, any side effects will be carefully evaluated. If side effects occur, an alternative medication or a reduction in statin dosage may be offered.

People who couldn’t reach their goals for cholesterol levels taking statins may need high doses or additional medications. Other non-statin drugs include ezetimibe and, less commonly, fibrates or niacin.

Additionally, you can consider some beneficial food supplements. They can also dramatically lower your cholesterol and triglyceride levels. Looking ahead we can say that nutritional supplements work independently and can be used with statins. But we’ll expand on that that in the following articles.

And finally, if you are not ready to start statin therapy or want to understand your risks and potential benefits, there are additional tests. We are talking about such medical research as the calcium index of the coronary arteries or computed tomography of the heart. It is worth clarifying that intimal thickness assessment is no longer recommended for CVD risk assessment. So, for example, atherosclerotic plaques can occur in the absence of thickening of the intima-media9.

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vitamin D


Modern books on wellness management often mention Vitamin D. It is commonly called overall health hormone1. And it makes sense! Vitamin d function is to help prevent chronic diseases and affect people’s longevity in general. Meanwhile, vitamin D insufficiency affects almost 50% of the population worldwide. An estimated 1 billion people worldwide, across all ethnicities and age groups, have its deficiency. That is and why sustaining its optimum level is critically important for your health.  

What is unique about vitamin D is that we don’t only get with food but can also produce it in our body by being exposed to sunlight. It plays a major role in keeping bones healthy, therefore it insufficiency can lead to child rickets, and adult malacosteon (bone softening) and osteoporosis (bone loss). But this vitamin’s role is not limited to this function.

Role of Vitamin D

Some recent studies have shown that it sufficiency is also associated with lower risks of getting diabetes milletus, multilocular sclerosis, cardiovascular diseases2, and tuberculosis3.


Besides, it is vital for a healthy immune system4. Without sufficient its amount our immune cells cannot properly react to threats, making our body more vulnerable to infections. In addition, vitamin D affects both inborn and acquired immunity.

It’s worth mentioning that vitamin D has anti-cancer effect for various types of cancer5. Emerging research supports the possible role of it against cancer, fractures and falls, autoimmune diseases6, influenza, type-2 diabetes, and depression. That’s why many health care providers have increased their recommendations for vitamin D supplementation to at least 1000 IU7. So, a meta-analysis published in 2007 showed that this supplementation was associated with significantly reduced mortality.

By now we have received the evidence of an increased risk of prostate and endometrium cancer, esophageal, stomach and pancreatic cancer, bladder and renal cancer, Hodgkin’s disease and non-Hodgkins lymphoma caused by vitamin D deficit.

It is remarkable that randomized double-blind examination shows significant 60% decrease in general oncological risk among postmenopausal women who were treated with vitamin D and calcium, as opposed to those who received placebo treatment during 4 years of observation8. The studies show the optimum 25 (OH)D in blood serum for cancer prevention to be 40-60 ng/mL (100-150 nmoles/L).

In addition, lower levels of vitamin D adjusted for BMI are also associated with an increased risk of hypertension9. Therefore, given the relatively safe and inexpensive route of vitamin D supplementation, some studies recommend prescribing vitamin D to hypertensive patients who fall below the target.

Chronic fatigue, low spirits may also be caused by vitamin D insufficiency. Besides, muscle weakness is considered a clear indicator of its clinical deficiency. Clinical symptoms of myopathy deficiency include proximal muscle weakness, diffusive muscle pains, and balance disorder. It also reduces age-related and general inflammations, which is critically important for cognitive function retention.

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How to Measure Vitamin D Levels

Your vitamin D can be tested in a blood test which measures its content (25-OH vitamin D). 25(OH)D is the main metabolite of it in the blood. Two main forms of 25(OH)D are cholecalciferol (D3) and ergocalciferol (D2). D3 is mainly formed in our skin under ultra-violet rays, while the source of D2 is food. Significantly, 25(OH)D concentration is made up of these two components, both forms are measured equimolarly. 25(OH)D is considered the best indicator of vitamin D in the body.  

Sun Exposure and Vitamin D

As mentioned above, you can get enough vitamin D in daily sun exposure. It happens because sunlight enables our body to synthesize it from cholesterol. To achieve this effect, some scientists recommend exposing about a third of your skin to the sun. This means that for most fair-skinned people, wearing a T-shirt and shorts for 10-30 minutes three times a week during the summer will be sufficient10. People with darker skin may need a bit longer than this.

However, a Korean study did not confirm the effectiveness of this recommendation. The experiment was Korean adults aged 20–49 years with serum 25-hydroxyvitamin D (25[OH]D) levels of < 20 ng/mL11.

The results showed that the sunlight exposure group showed a slight increase in serum 25(OH)D level. The sunlight exposure group had sunlight exposure on 20% to 30% of their body surface areas for 30–60 minutes per day, 3 times a week during the summer season.

Let’s see how much of vitamin D can be obtained through sunbathing? A Norway study found that 30 minutes of midday summer sun exposure of the whole skin is equivalent to taking 10,000-20,000 IU vitamin D orally12. At the same time, the winter levels of vitamin D are 10 to 100% lower than the summer levels. That means people in Norway cannot get vitamin D from sunlight between October and March.

There are a lot of factors that can affect your ability to make vitamin D from sunlight. Firstly, it depends on how sensitive your skin is to sunlight. Other factors include the time of day, your skin color, and how far you live from the equator. Secondly, it should be taken into account how much skin you expose to sunlight and whether you’re wearing sunscreen.

Does sunscreen reduce vitamin D production?

Since we mentioned sunscreen, let’s see how it affects vitamin D. Some studies estimate that sunscreen of SPF 30 or more reduces vitamin D production in the body by about 95–98%13. However, several studies have shown that wearing sunscreen has a small impact on your blood levels during the summer141516. Perhaps the differing results are related to different factors and the duration of the experiments. Another possible explanation is that even though you are wearing sunscreen, staying in the sun for a longer period may cause enough vitamin D to be made. Anyway, the effect of sunscreens on circulating vitamin D levels remains debated.

In conclusion, in order to resolve the dilemma of sunscreens, you may try going without sunscreen for just the first 10–30 minutes. This period should depend on how sensitive your skin is to sunlight. And then you need to apply sunscreen before you start burning.

This article was last reviewed on 12 March 2020. This article was last modified on 10 February 2020.

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Type 2 diabetes mellitus is rising at an epidemic scale throughout the world. Up to a certain moment, diabetes 2 (DM2) develops as a latent pathology which accounts for its late diagnosis and onset of therapy. Hence, the high frequency of vascular complications, early disablement, and mortality. Therefore, the improvement of screening studies is of primary importance for the detection of metabolic disorders. Glycated Hemoglobin A1C test is a simple laboratory screening test that can provide a direct measure of how your body is processing sugar in the blood.

This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 13 April 2022.

Let’s consider who is recommended to take this clinical laboratory test, why it is important, and what glycated hemoglobin counts are considered normal. Also, we will consider the advantages and disadvantages of this test, as opposed to checking blood sugar levels. But we will begin with the meaning of Glycated Hemoglobin A1C test.

Glycation and Glycosylation

Glycation and glycosylation refer to the process of attaching a glucose or sugar molecule to another molecule such as protein or fat. The more sugar there is in circulation in the bloodstream, the more sugar molecules there are to stick to fat and protein, in other words, to glycate them. You control your rate of glycation by the amount of sugar and high-glycemic index foods that you eat.


Chronic consumption of sugar and high-glycemic-index foods leads to persistent increased formation of Advanced Glycosylated End products (AGEs). These AGEs are sticky conglomerations of sugar and protein that gum up your enzymes. It leads to adding the burden of toxic waste that must be handled by your detoxification system. This accelerates the aging process in body tissues by covering them with sugar. Besides, it also leads to many of the chronic complications of diabetes, such as blindness, renal failure, and neuropathy.

Glycated Hemoglobin A1C blood test, which reflects chronic blood glucose values, is routinely used in monitoring glycemic control. It’s also called HbA1c test, hemoglobin A1C, and glycohemoglobin. The significant reduction in microvascular complications with lower A1C has led to the recommendation that A1C be used for screening and diagnosis of diabetes. Accumulating evidence suggests that racial differences in A1C values may be present. Despite these caveats, A1C can be measured accurately in the vast majority of people. The convenience of this test enables detecting diabetes in millions of people who have it but are not currently diagnosed with it.

In other words, Glycated Hemoglobin A1C lab test shows the average glycation level over the past three months. 1 per cent elevation of HbA1C means that your sugar level has increased by 30 points (in mg/dl) over this period. Thus HbA1C higher than 6.3 is a red flag for diabetes free people. It means that it’s time to reevaluate their eating habits and choose low-glycemic-index foods and avoiding foods with high sugar contents.


Almost 2,500 years ago it was noticed that ants were attracted to the urine of some individuals. So, in the 18th and 19th centuries, the sweet taste of urine was used for diagnosis of diabetes before chemical methods became available.

When Should Glycated Hemoglobin A1c Be Tested?

The American Diabetes Association® (ADA) recommends screening for prediabetes and diabetes beginning at age 35 for all people1. In the presence of risk factors, diagnosis of diabetes should begin earlier. The risks include the following factors:

  1. overweight (≥ 25 kg/m2) combined with such risk factors as:
    • sedentary lifestyle
    • parents diagnosed with diabetes mellitus
    • belonging to certain ethnic groups with high risks of diabetes mellitus
    • women with a newly born baby weighing more than 4.5 kg or women having gestational diabetes
    • elevated blood pressure (140/90 mm of mercury) or antihypertensive medication therapy;
    • low level of high-density lipoproteins (HDL) less than 0.9 mmoles and/or triglyceride level higher than 2.82 mmoles/l
    • polycystic ovary syndrome
    • HbA1c level equal to or higher than 5,7% as well as impaired fasting glycemia or glucose intolerance shown in previous tests
    • other clinical conditions associated with insulin resistance (super obesity, acantosis nigricans, etc.)
    • cardiovascular diseases in medical history.
  2.  In the absence of the above factors, diabetes testing is recommended to all people older than 40.
  3. If the test result is within the norm, re-testing should be done no later than in 3 years, with room for more frequent cause-specific testing based on initial result and risk factors.
  4. WHO recommends taking the test every three months to every patient diagnosed with diabetes mellitus

The USPSTF recommends screening for prediabetes and type 2 diabetes in adults aged 35 to 70 years who have overweight or obesity2.

And the USPSTF recommends considering screening earlier in patients with higher risk (i.e., one of the following):

  • family history of diabetes;
  • members of certain racial and ethnic groups (i.e., blacks, American Indians or Alaska Natives, Asian Americans, Hispanics or Latinos, or Native Hawaiians or Pacific Islanders);
  • personal history of gestational diabetes;
  • polycystic ovary syndrome.

At the same time, many health organizations try to build more advance way to define people who need to take a diabetes screening test. For example, The Canadian Task Force on Preventive Health Care released an updated guideline calling for more precision in type 2 diabetes screening. The guideline, prepared by the independent panel of 14 clinicians and experts, suggests using a risk calculator to identify patients with high risks of diabetes. But this questionnaire is intended just for adults aged 40 to 74 years 3.

People who have diabetes need this test regularly to see if their levels are staying within range.

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A1C Versus Glucose Testing

Both of these tests are utilized significantly to diagnose diabetes. The usage of glucose screening was the “gold standard” for the diagnosis of diabetes for many years. But this testing suffers from several deficiencies.

For example, the requirement to take blood on an empty stomach. But the most important deficiency is that numerous factors can influence results of blood tests. For example, taking various medications, doing physical activity the day before and so on may result in obtaining inaccurate data. Moreover, fasting glucose concentrations vary considerably both in a single person from day to day and also between different subjects.

Before blood donation, the should be no exercise stress (running, climbing stairs), or any emotional excitement. Before the procedure, you need to rest 10-15 minutes. Calm down. Blood glucose results may be altered due to eating, prolonged fasting, or physical activity. All this reduces the accuracy of the analyses and creates additional difficulties.

HBA1c blood test can be taken amid at whatever time of the day. The investigators concluded that HbA1c testing has a higher sensitivity for identifying patients at risk for diabetes vs FPG.

What Are Normal Levels of Glycated Hemoglobin A1c?

glycosylated hemoglobin A1C level below 5.7 percent is considered normal4. An A1C result between 5.7 and 6.4 percent (39-47 mmoL/moL) signals prediabetes. Patients with prediabetes should be tested yearly in order to determine whether they have converted to diabetic status. For people with type 1 diabetes, a blood sugar test is recommended.

It is worth mentioning that glycated hemoglobin in the range of 5.7–6.4% (prediabetes), especially in combination with a slight increase in fasting glucose, is associated with an increased risk of mortality, CVD, stroke and coronary heart disease5.

Type 2 diabetes is diagnosed when the A1C results are over 6.5 percent.

Healsens is there to help you with HbA1C screening test schedules regarding all the above factors. Follow us to get news about ways of drug-free control and lowering of HbA1C levels if needed. You can also download our app to use diagrams which will help you monitor changes.

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Drastically reduce the time to detect chronic diseases & inspire healthy habits

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wat zegt crp waarde


C-reactive protein CRP is a protein made in the liver that indicates the amount of inflammation in the body. Like elevated homocysteine, a high CRP level increases one’s vulnerability to cardiovascular disease, Alzheimer’s, and cancer. Such an increase in CRP levels may be caused by infection, inflammation, trauma, diabetes, as well as certain medicines. In the absence of these main factors, elevated CRP indicates future risks of heart attack.

This article was last reviewed on 10 April 2019. This article was last modified on 14 February 2020.

In addition, increased systemic inflammation is a sign of aging. Therefore, C-reactive protein (CRP) can be classified as a marker of healthy aging1.

It has been found that this marker predicts well the risk of developing age-related diseases and human life span2.

What is the difference between CRP and hs-CRP?

As you’ve no doubt guessed, the difference between CRP and hs-CRP is contained in the “hs” abbreviation – “high sensitivity.”


Traditionally, CRP, or C-reactive protein, is measured down to concentrations of 3 to 5 mg/L; hs-CRP is measured down to concentrations of approximately 0.3 mg/L. This improved sensitivity allows hs-CRP to be used to detect low levels of chronic inflammation.

So, high-sensitivity C-reactive protein (hsCRP) lab test is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals with no history of cardiovascular disease. Elderly people with high CRP levels are more vulnerable to serious diseases than their relatives with low C-reactive protein levels.

Which level is considered the norm?

Concentrations less than 1 mg/L indicate low risk of cardiovascular disease.
1 to 2,9 mg/L levels suggest average risk. Concentrations above 3.0 mg/L indicate a high risk of cardiovascular disease

Look at the general guidelines for hs-CRP scores:
● Low risk of cardiovascular disease: Less than 1.0 mg/L
● Average risk: 1.0 to 3.0 mg/L
● High risk: Above 3.0 mg/L

A reading above 10 mg / L can signal the need for further testing to determine the cause of this significant inflammation in your body. Moreover, tests showing serum CRP levels above 10 mg / L in apparently healthy men or women should be repeated after a month3. This is done in order to exclude a latent infection or other systemic inflammatory process.

As you can see, a reading above 10 mg/L may signal a need for further testing to determine the cause of such significant inflammation in your body. It’s worth mentioning that levels of hs-CRP less than 10 mg/L are significant for cardiovascular risk stratification. Higher hs-CRP levels may be the sign of acute inflammation, a chronic illness, a trauma, etc.

C-Reactive Protein as a Biomarker of Cardiovascular Disease

In recent years, hs-CRP has been endorsed by several public health organizations as a biomarker of cardiovascular disease risk45.

As for primary prevention, a number of prospective epidemiological studies have shown that the high-sensitivity method in detecting CRP is highly predictive of cardiovascular accidents6, peripheral vascular diseases, ischaemic strokes, and sudden cardiac death risks even if the patient is virtually healthy. Other major studies in the USA and Europe have proven hs-CRP levels to be a better risk indicator than low-density lipoprotein cholesterol levels. Moreover, since hs-CRP reflects a different cardiovascular risk component, a combination of hs-CRP and lipoprotein profile would significantly enhance total risk estimation. Thus, LDLC levels higher than 160 mg/DL and high hs-CRP levels signal a need to discuss “aggressive” primary prevention and lifestyle changes with your doctor and start a drug therapy in case of therapeutic indications.

Do I need to check my hs-CRP levels if I feel well?

Factors that increase hs-CRP levels are quite numerous. They include obesity, elevated blood pressure, diabetes mellitus type 1 and 2, acute situational reaction, sleep disturbances, etc. In order to make allowance for all the major factors, Healsens will provide your physical assessment, generate your individual profile and help determine the necessity and frequency of controlling your hs-CRP levels.

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What if my C reactive protein CRP level is high?

As we wrote above, for hs-CRP values exceeding 10 mg / L, it is recommended to undergo additional testing to find the causes of inflammation. Since such high levels of hs-CRP are associated with acute inflammation, chronic disease, trauma, etc.

For values below 10 mg / L, the good news is that giving up smoking, regular physical activity, as well as weight-reducing treatment, can lower basic hs-CRP level without any medical help. Healthy eating habits7, green tea89, controlled drinking, sufficient vitamin D1011, vitamin C12, and vitamin K13 in your body can also reduce the level of the reactive protein in the body.

In addition, glucosamine may reduce cancer mortality by lowering C-reactive protein levels. Therefore, if C-reactive protein is higher than 1 mg / L and there are no contraindications such as HOMA-IR14 is not increased, then therapy with this substance at a dosage of 1500 mg per day can reduce cancer mortality and overall mortality15. This is due to a decrease in inflammation, which will be reflected in a decrease in the inflammatory marker C-reactive protein, as expected by about 23%.

The same effect can be achieved through certain medications, such as16:

  • cyclooxygenase inhibitors(Aspirin, Rofecoxib, Celecoxib)
  • thrombocyte aggregation inhibitors (Clopidogrel, Abciximab)
  • cholesterol management products (statins, ezetimibe, fenofibrate, nicotinic acid)
  • beta-adrenergic blocking agents and angiotensin
  • converting-enzyme inhibitors (Ramipril, Captopril, Fozinopril)
  • anti-diabetes drugs (Rosiglitazone, Pioglitazone).

In case any medications must be taken, discuss your therapeutic regimen with your doctor.

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checking homocysteine serum levels

Checking Homocysteine Serum Levels

Homocysteine is produced in our body (it is not contained in food) through the metabolism of an essential amino acid called methionine. Normally, formed homocysteine quickly turns into other, harmless substances – vitamins B6, B12, and folic acid are needed for these transformations. But in elevated concentrations, homocysteine provides a whole range of adverse effects, which we will discuss in detail below. Also, Also, this article describes who and why may benefit from checking homocysteine serum levels in terms of improving health.

Firstly, it can directly damage vascular walls by making them loose. Thus, the damaged surface is subject to cholesterol and calcium depositing, which form an atherosclerotic plaque. Thus, blood coagulation is activated, and this, in turn, leads to the development of atherosclerosis, arterial and venous thromboses.

Secondly, folic acid deficiency, which almost always accompanies an increase in homocysteine, can lead to gross malformations of the fetal nervous system during pregnancy – anencephaly (lack of the brain), and neural tube failure. It is for the prevention of these defects that all pregnant women are prescribed folic acid preparations.

Thirdly, homocysteine in high concentrations has a direct toxic effect on trophoblast cells, from which the placenta is subsequently formed, causing their death and a decrease in the production of hCG – the pregnancy hormone. This can lead to termination of pregnancy (usually in the first trimester) or to impaired placental development, which further increases the risk of placental insufficiency, fetal growth retardation, preeclampsia, placental abruption, pregnant hypertension, and kidney damage.

Elevated homocysteine levels are also associated with increased thrombus formation, as well as higher risks of heart attacks, cerebral accidents, peripheral arterial diseases, and fractures.

Doctors measure homocysteine levels as a possible cardiovascular risk factor, to diagnose homocystinuria, thrombosis, diabetes mellitus, senile dementia and Alzheimer’s, and obstetric pathology. The testing is necessary in a number of situations since elevated homocysteine levels are cytotoxic.

Which level of Homocysteine passes for normal?

The “ideal” homocysteine level levels of about 5-7 µmol/L1.

Good” levels of less than 10 µmol/L2. So, homocysteine > 10 μmol/L is associated with some risk factors like peripheral microvascular endothelial dysfunction (PMED), higher major cardiovascular events, etc.

The normal range of homocysteine levels are less than 15 micromoles per liter (mcmol/L).

Higher levels are: Moderate (15 to 30 mcmol/L); Intermediate (30 to 100 mcmol/L); Severe (greater than 100 µmol/L).

Any higher than 15 and you will want to work with your Health Coach to further investigate the cause.

The latest studies show that homocysteine is an independent risk factor of cardiovascular diseases3. Clinical research shows that a 5 umol/L elevation in homocysteine concentration in blood plasma increases the vulnerability to cardiovascular disease and total mortality by 1.3 – 1.7 times. Lowering of elevated homocysteine levels in blood plasma can prevent cardiovascular complications.

If levels of homocysteine are found to be elevated, it is advisable to measure the levels of creatinine, thyroid stimulating hormones, folacin, cobalamine to define probable causes of hyperhomocisteinemia and suggest appropriate treatment.

Homocysteine, total

Test Code: 31789
Specimen Type: Blood

Acceptable screening test for disorders of methionine metabolism (congenital hyperhomocysteinemia).

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Causes for High Homocysteine Levels

At first, don’t panic if your homocysteine level is above the norm values.

Just because you have high homocysteine doesn’t mean you will develop heart disease or a neurological condition tomorrow, next week or even next month.

That’s the beauty of functional lab tests; they often allow us to catch patterns of disease and imbalance in the body before they become chronic or diagnosable. And if you’re already dealing with a chronic disease, then by examining your homocysteine levels, you’ve gotten one big step closer to uncovering the root cause and getting your health back on track.

It’s worth mentioning that smokers are more vulnerable to hyperhomocysteinemia. Moreover, high coffee consumption is one of the most powerful factors increasing homocysteine in blood. Those who drink more than six cups of coffee a day have 2-3 umol/L higher homocysteine levels than people who drink no coffee.

Elevated homocysteine levels are often associated with a sedentary lifestyle. So, moderate physical activity lowers homocysteine levels in case of hyperhomocysteinemia. Vegan diet can also decrease its levels by 13% without any supplements.

However, the most frequent cause of high homocysteine levels is folacin deficit4. The deficit of cobalamine (vitamin В12) may also lead to homocysteine accumulation5. However, the effectiveness of using vitamins is a subject of debate among researchers. Several major randomized experiments showed that relatively easy lowering of homocysteine levels through taking supplements did not result in lowering vulnerability to cardiovascular diseases6.


How Often Should You Check?

As with all lab work, how often to re-test is highly individual. Yet, there is a number of indications for investigation, such as:

– cerebral accident, heart attack, thrombosis, atherosclerotic cardiovascular disease in family history;
– blood-clotting disorder;
– neurological disorders in childhood;
– preparation for IVF, pregnancy;
– chromosomal abnormality of the fetus, congenital defects, complications;
– smoking;
– age higher than 75 years old.

Typically, if your levels are on the high-side your Health Coach will recommend re-testing after about 6 months.

In conclusion, some estimates suggest that if homocysteine levels decreased by 40% would lead to an extra 8 years of life per 1000 men, and 4 years of life per 1000 women.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

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Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits


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