Breaking Down Blood Markers: HbA1C
by Dr. Mitchell Rasmussen, DC, CFMP, FRC-ms
In the conventional medical model, you'll get your annual bloodwork run and when things come back in "range", your doctor simply says, Everything Looks Good, and you move on. ..But do you ever get a chance to truly understand those markers?! What is the 'normal range' anyway?!
In this series, Dr. Mitchell Rasmussen breaks down blood markers from a functional medicine perspective. We talk about tighter functional lab ranges, and WHY numbers outside of range matter, and HOW to address them using lifestyle intervention.
LESSON TWO: Hemoglobin A1C (HbA1c)
When it comes to blood sugar and diabetes risk assessment, one of the most useful biomarkers is Hemoglobin A1c.
This is a measure of chronic blood sugar control. Levels of A1c reflect the average blood sugar control in the previous 2-3 months.
About 6% of Hemoglobin A consists of molecules that have been partially modified by attachment of a glucose molecule. This process is known as ‘glycosylation’ and the glycosylated hemoglobin is called “hemoglobin A1”.
There are numerous subgroups to this, but the most important is A1c.
The degree of glycosylation (read: damage) of Hemoglobin A is directly dependent upon the concentration of blood glucose and the length of time the protein is in circulation.
Since glycosylated hemoglobin levels represent a time averaged blood glucose, they are considered to be a better indicator of control than an individual blood sugar test.
Changes to A1C.
Because A1C this is a long-term blood sugar control marker, it won’t change much at the outset of a lifestyle intervention for elevated blood glucose or insulin resistance.
It will take a few weeks of eating bad for your levels to rise, and it will take about a month of proper intervention to see this value decrease.
As a rule of thumb, a 1% change in Hemoglobin A1c corresponds to a change of 30-35 mg/dl in average blood sugar level.
Celebrate the small things.
Small changes to A1c should be celebrated with those of us who struggle with insulin resistance or blood sugar dysregulation.
This is the long game. We know that insulin resistance drives inflammation and inflammation begets itself.
BOTTOM LINE : You best believe Hemoglobin A1c is a marker we will track with you if insulin resistance is one of the triggers for your unique picture.
How do we manage these issues in the context of Functional Medicine?
Test > Treat > Step back and re-assess > Tweak as needed > Continue Progress
Functional Medicine is personalized lifestyle medicine tailored solely around the needs of each patient.
There are no boxes we need to fit in. We want to know any concerns, new symptoms, changes, etc. you may have going forward. Dietary choices and lifestyle habits are primary drivers of our health. It sounds so cliché, BUT it’s true. All of the high-end metabolic testing and nutrient protocols would be for naught if we didn’t support a true lifestyle change. It comes from education about what exactly to eat and what habits to put in place.
This is NOT going to be an easy, straight-shot, no bumps in the road kind of affair. This is your life we are helping you take back control of.
We are all in this with you.
The support I have from my team, as well as the experiences we’ve gained together having treated complex cases, gives me great excitement at the possibilities for anyone’s long-term health projection. I believe strongly that if you follow through with the guidance earned through your sessions with my team and me, you will achieve a level of health that you likely assumed was never again possible for you.
Health is a VERB, not a NOUN.
Want to work with a functional medicine doctor to run labs and assess nutrient status? Struggling with hormone imbalance, IBS, weight gain, mood changes? Let's look at BIOCHEMISTRY. Read more about Functional Medicine at The Facility here.
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