Almost all of us think we could, and should, be healthier. We think that if we did those things we know we are supposed to do -- ate better, exercised more, reduced stress, quit smoking -- we would feel better, look better, have more energy, and get those weight, blood pressure, and cholesterol numbers down where they should be. And that's all true. The problem is turning all those ideas and goals into a plan of action. How do you get started when your goals are so broad?
The key, as with so many things, is to start with where you are now: your baseline. When it comes to health, your baseline is a whole atlas of personal health information. Knowing how to read that atlas can help you to set goals on your wellness journey -- and to achieve them.
Your Biomarkers, Small and Large
If you are like most people, your own assessment of your health may not be as accurate as you think it is. It's probably based on a combination of current concerns (such as high cholesterol readings) and past perceptions -- that you're a relatively fit person who eats pretty well, for instance. The best way to test your health self-image against reality is to check your baseline. Your baseline is the whole made up of the parts called biomarkers -- all of the tests and measurements we encounter in a doctor's office, clinic, or hospital.
Your body is engaged in constant conversation -- in a sense, it is a conversation. Each of your cells and organs is constantly sending and receiving microscopic messages at mindboggling speed. The body's feedback system dwarfs the Internet in its magnitude, sensitivity, and subtlety. Biomarkers are indicators of the body's molecular conversation.
Your Laboratory Exams, Your Lab Biomarkers
Biomarkers may tell us what's wrong with us, but more importantly, they track changes in your health over time. You can think of your biomarkers as your wellness biography. A list of lab test results can serve as a snapshot of a person's health. But a record of your biomarkers over time is a kind of biographical movie that chronicles the changes you go through over a lifetime.
Your Physical Biomarkers
Basic physical exams -- having your pulse and blood pressure taken, your heart and lungs listened to, your height and weight measured -- may seem old hat. And indeed, most biomarkers are measurements taken at the cellular and molecular levels. But a physical exam and the discussion that happens between patient and doctor are essential to putting those lab tests into context.
During a physical exam, your doctor may measure or examine your:
- Blood pressure
- Waist circumference
What Your Biomarkers Look At
Most biomarkers are measurements taken at the cellular and molecular levels in an attempt to detect the presence of a wide range of substances and provide information about the function of every organ and system in the body.
River of Life: Blood Sustains and Protects
Your blood has many components. The most prevalent are red and white blood cells (RBCs and WBCs) and cell fragments called platelets, which play roles in blood clotting. RBCs carry oxygen from the lungs to tissues throughout the body and to then return carbon dioxide from those tissues to be exhaled in the lungs. WBCs are part of your body's immune system. When a pathogen enters the body, a system of WBCs mobilizes in a coordinated defense response to eliminate, neutralize, or mark the invader for destruction.
The liquid portion of blood is called plasma ,and it carries nutrients, electrolytes, waste products, hormones, and more throughout your body.
Tests your doctor may order for heart and vessel health:
- Red blood cell indices
- White blood count
- Platelet count
The Heart of the Matter: Dietary Fat and Vessel Health
Your cardiovascular system consists of your heart and blood vessels. More than just a transport system, the cardiovascular system is a sensitive barometer of health conditions, including diet. Everything a person eats, including dietary fats, is reflected in blood chemistry and the health of the heart and blood vessels.
Fats have gotten a bad rap, yet they're vital to our health. There are many different types of fats, and they play different roles and have different effects on your body.
Tests your doctor may order for dietary fat and vessel health:
- Total cholesterol
- Low-density lipoprotein (LDL)
- High-density lipoprotein (HDL)
- High-sensitivity C-reactive protein
All Charged Up: Electrolytes and Vitality
Most Americans know electrolytes are important for health due to the marketing of sports drinks. Electrolytes have numerous jobs in the body. They transport substances into and out of cells and enable the transmission of nerves impulses and the contraction of muscle fibers. They maintain the body's fluid balance, help regulate the body's pH balance, and are used to build bone and produce digestive acids.
Tests your doctor may order for electrolyte health:
- Carbon dioxide
Detox and Digest: Your Busy Liver
Your liver is your body's central chemical plant. It filters blood and removes toxins, stores sugars, lipids, and vitamins, and produces important blood proteins. The liver also produces most of body's cholesterol, as well as a quart of digestion-aiding bile each day.
Remarkably, the liver can regenerate itself even if two-thirds of its cells have been lost. But the liver is also susceptible to chronic damage from hepatitis infection, alcoholism, drug side effects, exposure to toxins, obesity, and diabetes.
Tests your doctor may order for liver health:
- Serum total protein
- Alkaline phosphotase
Food into Fuel: The Multitasking Pancreas
Your pancreas produces two vital hormones, glucagon and insulin. They keep levels of glucose, your body's main fuel, in a narrow, healthy range. In diabetes, this balance is disrupted. Out-of-control glucose levels damage blood vessels, both large and small, throughout the body. This can have many damaging consequences, including cardiovascular disease, blindness, kidney disease, and neuropathy.
Tests your doctor may order for pancreas health:
- Hemoglobin A1c
Your Biggest Supporters: Healthy Bones
Human engineers and architects have devised some remarkable construction materials and structures, but they still haven't come close to matching a human skeleton. Your bones not only bear your body's weight and make possible a remarkable range of motion, they also store minerals, protect internal organs, and produce blood cells.
Old bone is constantly being broken down and replaced with new bone, at a rate of about 10 percent a year. Bone mass peaks between the ages of 25 and 30 years; after that, bone loss outpaces bone formation.
Tests your doctor may order for bone health:
- Vitamin D
Your Kidneys: Not Just A Waste Disposal Team
Your kidneys do a lot more than just filter your blood -- impressive task though that is. Each day, your kidneys filter about 200 quarts of blood to extract about two quarts of wastes, which is then eliminated as urine. They monitor your body's fluid balance and thereby help regulate blood pressure. They are constantly checking and adjusting levels of key substances in the blood such as EPO, which stimulates the creation of red blood cells.
Because they are so densely packed with tiny capillaries, your kidneys are vulnerable to disorders that affect blood vessel health. High blood pressure and diabetes can cause them irreversible damage.
Tests your doctor may order for kidney health:
- Urine analysis
- Urine total protein
- Urine microalbumin
- Estimated GFR
- Uric acid
- Blood urea nitrogen
Sexual Health, Preserving Reproduction
Sexual health is a complicated business. It clearly involves a broad range of concerns about fertility, reproduction, and sexually transmitted disease. But sexual health includes issues of emotional wellbeing and quality of life as well.
Hormones are central to any discussion of sex. Testosterone, the principal sex hormone in males, is present in both males and females, but men produce 10 times as much as women. Testosterone is responsible for maturation of the male sex organs, sperm production, and masculine physical characteristics.
Likewise, estrogens -- the primary sex hormones in females -- are also present in small quantities in males in smaller amounts. Estrogens are responsible for the development of female sex organs, and play key roles in the menstrual cycle and pregnancy.
Tests your doctor may order for sexual health:
- HIV screening
Setting the Pace: Thyroid and Metabolism
The thyroid is a small, butterfly-shaped gland located at the base of your neck. It produces two main hormones, triiodothyronine (T3) and thyroxine (T4). The influence hormones exert on physiological processes is staggeringly fast and powerful. T3 and T4, which help maintain body temperature, heart rate, moods, energy levels, bowel function, and rates of fat, and protein and carbohydrate metabolism.
Hormones almost never act in isolation. The thyroid is under the control of a hormone called TSH (thyroid-stimulating hormone), produced by the pituitary gland. The pituitary gland, in turn, takes its orders from the hypothalamus, which decides which particular hormones the pituitary should release and when.
Tests your doctor may order for thyroid health:
- Free throxin
- Thyroid stimulating hormone
In Defense of You: Your Immune System
Your body has two types of immune systems. One, called innate immunity, relies on different types of white blood cells that seek out and destroy foreign cells.
The other, termed adaptive immunity, relies on antibodies that circulate around the body and tag invaders for destruction. In this way, cellular "memories" are formed about the identity of each particular invader so that a specific defense can be launched each time that pathogen is encountered. Vaccines are possible because of the adaptive immune system.
Tests your doctor may order for immune health:
- Hepatitis A, B, and C
- Flu identification
- C. dificile
- West Nile
- Rheumatoid factor (RF)
- Tissue transglutaminase antibody (tTG)
Monitoring Cancer: What Cells Tell Us
For many years, cancer was generally diagnosed too late for treatments to be effective. Now, with improved diagnostic technology and expanded treatment options, the focus has shifted to early detection and aggressive treatment.
But the utility of screening and treatment differs from cancer to cancer. For some cancers there is little or no chance of survival without treatment. But in other types of cancer, it's uncertain whether treatment will help a person live longer. This is important to consider when the effects of treatment can severely damage a patient's quality of life.
In the future, we can expect that the combined results of blood tests, imaging scans, and genetic tests will help narrow diagnosis and focus treatment, opening up new opportunities in cancer care.
Tests your doctor may order for cancer screening:
- Prostate specific antigen (PSA)
Reading Your Mind: The Future of Brain Imaging
Disorders of the mind threaten our very concept of self, and doctors have had frustratingly few tools when it comes to screening (detecting disease before symptoms appear) and diagnosing neurological health. Now, though, promising new technologies for diagnosing disorders such as Alzheimer's, Parkinson's, ALS, multiple sclerosis, and depression are being developed. Progress on developing new tools for screening is slower.
Tests your doctor may order for brain health:
- Post-traumatic stress disorder
- Brain injury
Mapping Your Future: Screening for Disease Risk
The Human Genome Project was heralded as ushering in a new era of personalized medicine -- but that era might not arrive as early as hoped. Knowing an individual's unique genetic makeup will eventually make possible the targeting of both preventive care and treatment. But genetic testing raises ethical as well as medical issues, and these issues will get only more complicated in the future.
It's important to bear in mind that in most cases genetics can tell us only that we are predisposed to getting a disease; a wide range of nongenetic factors will always be involved. Our genes are not our destiny.
Tests your doctor may order for genetic screening:
- Tay Sachs
- Cystic Fibrosis
- Breast cancer
Trends in Baselining
In the future, baselining your health will expand beyond blood, urine, and imaging tests. Diagnostic medicine will advance on many different fronts, including more sensitive molecular tests, more sophisticated imaging scans, as well as high-tech breathalyzers, diagnostic digital "noses," and artificial intelligence.
What Do You Want?
After Your Visit
By obtaining an accurate baseline, you have embarked on your wellness journey -- that's step one. Step two is to see the value of serial testing. This is key to seeing health and wellness as a lifelong process.
Can we put our wellness goals into action in our own lives? Ultimately, it boils down to motivation. What do you want and why is it important?
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