December 10, 2006
Other
Question from Glencoe, Illinois, USA:
My husband goes to a hormone/longevity clinic that had him take a rash of blood tests. I asked for copies of the blood test results. His fasting glucose level was 94 mg/dl [5.2 mmol/L], which I know is technically normal, but the higher end of normal. But, the bigger reason I’m concerned is that his “Insulin (Specimen 1) level was only 3L.” The laboratory, Quest Diagnostics, red-flagged this as what I assume is clinically low (showing the normal range as 6 to 27 uIU/ML), yet my husband’s nurse practitioner is not concerned! Should I be concerned?
Other tests that were red flagged (in case they are pertinent) are: DHEA–low: 41L (normal: 80 to 560 UG/DL); his good cholesterol–low: 35L (normal is over 40mg/dl); TSH, Serum–low: 0.33 L (normal 0.40 to 5.50 uIU/mL). Furthermore, they put him on Armour thyroid, even though he was not clinically low, but what they considered to be subclinical–this TSH, serum low level is SINCE he was on thyroid–before it was normal!)
I must say I’m not feeling overly confident about his nurse/doctor, but the insulin result is my main concern. What do you think?
Answer:
I would not be concerned about the low insulin level in the presence of a normal glucose. The low insulin level would be a concern if the blood sugar were too high and the insulin level were inappropriately low. Your husband’s result suggests he has reasonably good insulin sensitivity. I do not usually test for insulin levels in the presence of normal glucose, because there is not good evidence to show this is helpful for an immediate clinical endpoint. The low DHEA is not surprising. This value goes up with age, so it needs to be measured at 8:00 a.m. and compared to an age-appropriate normal range. The low HDL-cholesterol is concerning because this is a cardiac risk factor. Most interventions are directed at weight loss, exercise, and smoking cessation (if he smokes). The TSH of 0.33 is low and suggests too much thyroid around. If he started the Armour thyroid before the test, he may want to consider whether he really wants to take that. I would recommend he speak with his physician about these tests and get further guidance.
JTL
