Health, weight, and appearance are transformed by living the Undoctored Wild, Naked, Unwashed lifestyle. You can see it on the face with reduced puffiness and edema and smoother skin. You can see it on the waistline as inflammatory visceral fat recedes. You can perceive it as increased energy, reduced depression and anxiety, reduction or elimination of irritable bowel syndrome and acid reflux symptoms, reduced joint pain, reversal of leg/ankle edema, and in so many other ways.
But how about blood measures of health? You can witness the transformations there, too. And the transformations you see in blood markers of health can be just as dramatic and impressive as all the other changes. In my cardiology practice, we would obtain such measures prior to starting the program, then several months later and onward. Comparing starting values with later values revealed dramatic changes, attesting to the power of this lifestyle.
But first a warning: NEVER have blood drawn while you are actively losing weight (unless, of course, some urgent health issue crops up that requires it, such as bleeding or infection). The reasons are simple: Weight loss means that your body is mobilizing stored energy from fat cells, energy stored as triglycerides. (All fats are triglycerides whether it’s fat on pork or bacon, olive oil, or fat in fat cells.) Triglycerides and the fatty acids that comprise triglycerides therefore flood the bloodstream as you lose weight, making them available to “burn” and clear from the bloodstream. If you spun your blood down in a centrifuge to remove red blood cells, you would actually see a milky layer—those are triglycerides. But it means that any blood drawn will be filled with triglycerides and fatty acids. This means that blood levels of triglycerides can rise substantially, a phenomenon that temporarily cascades into many other effects including a drop in HDL cholesterol, formation of small LDL particles, erratic blood sugars and blood pressures. This whole process subsides as weight loss eventually plateaus, followed by gradual settling down of all these measures to far better values. HDL cholesterol, for instance, a useful index of overall health—the higher, the better—will rise over the ensuing two years, while triglycerides settle down over several weeks, reflecting the variable timeline in responsiveness of all these measures. So never have blood drawn during active weight loss. Have it drawn no sooner than 4 weeks after weight has plateaued, then expect further improvements to develop over time.
Once your weight has plateaued for at least 4 weeks, consider chronicling your wheat/grain-free experience with measures that properly reflect the metabolic transformation that develops, here are measures to consider:
Weight—Of course. Even better, track body composition with a body fat analyzer (preferably a foot-to-foot or hand-to-foot bioimpedance device). This will more accurately reflect what is changing, since not only is fat lost, but muscle increases on this lifestyle.
Waist circumference—After all, the whole conversation started by talking about Wheat Bellies.
Blood pressure—Expect a drop in both systolic and diastolic values.
Fasting blood glucose, HbA1c—HbA1c reflects your prior 60-90 days of around-the-clock blood glucose values. I aim for blood glucose 90 mg/dl or less and HbA1c 5.0% or less. Blood sugars and HbA1c plummet on the Undoctored lifestyle, especially after weight loss has subsided and you add all the other components of the Undoctored Wild, Naked, Unwashed program such as vitamin D and efforts to cultivate bowel flora (as discussed in the Undoctored book). HbA1c drops slowly, given that it relies on red blood cells dying off before it reflects drops in blood sugar.
NMR lipoproteins—This provides real measures of LDL particles—not the crude and useless marker, LDL cholesterol, that serves as an indirect gauge of LDL particles yet is the basis for the multi-billion dollar statin drug and cholesterol industry; we actually measure LDL particles’ number and size. By obtaining NMR lipoproteins (especially if compared to a prior panel before undertaking your Wheat Belly lifestyle), you would see that small LDL particles plummet. A typical response would be a drop from, say, 1800 nmol/L (particle count per volume) to zero or other very low value. Recall that small LDL is the #1 most common cause for heart disease in the U.S., not “high cholesterol.” Wheat/grain consumption increases small LDL particles; wheat/grain elimination is the most powerful tool available for reduction of small LDL particles, particularly when combined with weight loss. You will also see that HDL cholesterol rises and HDL particles increase in size and number, reflecting their greater protective potential. Triglycerides and the VLDL particles that carry triglycerides also plummet. (VLDL particles cause formation of small LDL particles; if VLDL particles are reduced to a minimum, they no longer contribute to creating small LDLs.)
C-reactive protein—The reason why so many people talk about c-reactive protein (CRP) is because the pharmaceutical industry has fueled the discussion about it in the media with absurd clinical trials like the JUPITER trial of Crestor in people with high CRP. But CRP and other measures of inflammation drop to the floor with wheat/grain elimination along with other Undoctored lifestyle efforts. A value of zero mg/dl is the rule.
Those are the essentials. But if you want to track some other factors once you are on the program and get a handle on overall health, consider:
Thyroid panel—That includes TSH, free T3, free T4, reverse T3, and thyroid antibodies. If thyroid antibodies are abnormally high, you have a thyroid autoimmune disease, most commonly Hashimoto’s thyroiditis, with at least half of cases triggered by prior wheat (gliadin) consumption. Now that you are wheat/grain-free, have restored vitamin D, and are cultivating healthy bowel flora, you can watch your thyroid antibody levels drop over time (typically months).
25-hydroxy vitamin D—This is the test to assess the adequacy of vitamin D supplementation with some contribution from sun exposure if you are young and allow substantial skin surface area to be exposed to the sun. We aim for 60-70 ng/ml for ideal vitamin D status.
RBC magnesium—A better measure than the more common serum magnesium, but even RBC magnesium underestimates tissue deficiencies. We therefore aim for the very top of the reference range.
Vitamin B12, methylmalonic acid—Because some people develop B12 deficiency from prior wheat/grain consumption and the various gastrointestinal distortions they introduce, it would be important to identify this and take steps to correct (discussed in Undoctored). Hypochlorhydria, or low stomach acid, for instance, often a consequence of autoimmune damage to the stomach’s acid-producing parietal cells, typically does not recover and B12 supplementation is usually necessary for a lifetime. (My preferred form is methyl B12 to sidestep MTHFR genetic variants that can impair absorption of other forms).
Serum iron, ferritin, CBC—Because prior wheat/grain consumption (via grain phytates) blocks nearly all dietary iron absorption, some people begin their Wheat Belly lifestyle with iron deficiency or iron deficiency anemia. While this usually corrects simply itself with wheat/grain elimination, an occasional person, especially menstruating females or those with severe symptomatic anemia, may need iron supplementation.
Serum zinc—Like iron, magnesium, and other positively-charged minerals, grain phytates block zinc absorption that can lead to a variety of zinc deficiency phenomena such as skin rashes and impaired immune responses. Like magnesium testing, we aim for levels at the high end.
I am a big believer in tracking your experiences. But you’ve also got to choose the right values to track. No sense in tracking the speed you are driving by looking at the odometer. There are many other measures you can make that are less relevant to the Undoctored experience, but the ones listed above can give you a comprehensive survey of the improved metabolic landscape that develops on this lifestyle.