When it comes to health and longevity, I espouse three (3) major considerations.
Deficiencies
Excesses
You are what you absorb - not (so much) what you eat.
These concepts may seem very broad. For example, how are these concepts related to more tangible health issues like heart disease and cancer? Well, these three are the basic drivers of the susceptibility to these diseases—and every other one—too.
To appreciate the impact of these, consider four (4) major health/disease pathways. I call them the R. I. D. E pathways.
Let's go down this list to determine which one may have the most significant impact on our health. Indeed, they all play a role, but might one rise to the top?
ENERGY:
This refers to metabolism. If you do not consume enough macronutrients to support metabolism, you may lack energy. However, even the S.A.D diet provides plenty of energy. Few, particularly in the developed world, are deficient in calories. So, is this an epidemic?
On the other hand, if you consume too many calories, does it really cause a lack of energy, as many pundits claim?
Here is the response when I ask AI if eating processed food can cause a lack of energy.
Does taking in too much "energy" cause a lack of energy? Does this make sense? Of course, I am overly simplifying this because we know that taking in excess energy through excess carbs and sugars (and even protein) will result in insulin resistance, leading to a lack of energy. However, when observing extremely overweight people, they seem to be managing okay. Sure, they are not running marathons, but...
Taking in too many calories is an evolutionary process. We historically go through "feast and famine" cycles, and our bodies accommodate that by storing excess calories (fat). We even store micronutrients in our bones (minerals).
Energy Conclusion: Humans developed natural processes to accommodate excess calorie intake. Indeed, people in developed nations no longer experience "feast and famine" cycles, so there is no real need to "feast" as we do. But our bodies can accommodate the excesses - to some degree.
Conclusion: Eating excess calories can lead to insulin resistance and harm. However, since we have mechanisms to accommodate these excesses, this is NOT a major cause of disease.
POINT TO PONDER. What do you think is more harmful, excesses or deficiencies?
Here are some considerations to "steer" your answer. When you take in excess, your bodies have mechanisms to create balance. Among them are the kidneys, liver, and spleen, which can remove excesses in an attempt to achieve balance.
Does our body have the same facilities to accommodate deficiencies? The answer is yes, but I assert they are much more harmful to your health.
Calorie Deficiencies: Your body consumes your stored fat.
Several authors have suggested the relationship between relative body weight and mortality within a given period is U-shaped or J-shaped (9).
*** The "J" shaped curve means that underweight people are at a much higher risk of early mortality within a given period when compared to those who are overweight.***
From reference 9 above:
"Conclusion: This quantitative analysis of existing studies revealed increased mortality at moderately low BMI for white men comparable to that observed at extreme overweight, which does not appear to be due to smoking or existing disease. Attention to the health risks of being underweight is needed, and body weight recommendations for optimum longevity must be considered in light of these risks.
Myth Buster
In his book Doctoring Data, Dr. Malcolm Kendrick discussed an article on body mass index and concluded that being underweight is much more detrimental to health than being overweight.
One could argue that being underweight is a clear sign of a lack of energy - or an inability to process foods into energy and that being overweight is an excess of energy. Regardless, our bodies have mechanisms to accommodate both - at least temporarily.
**The first is a deficiency, and the 2nd is an excess. Which is worse? I believe that question was answered above.
Pardon me for being graphic, but I believe these images make the point that being underweight (lack of food or the ability to process it - A DEFICIENCY) is much worse compared to being overweight - AN EXCESS.
Who would you rather look like?
IMMUNITY
Immunity is the body's process of identifying harmful "non-self" antigens. An antigen is a substance that causes the body to produce an immune response against it. Antigens can be found on the surface of cells, viruses, fungi, or bacteria and can also be nonliving substances like chemicals, toxins, drugs, or foreign particles.
The action of the immune system creates debris that the detox pathway must eliminate. Accumulation of this debris can trigger minor and, in some cases, minor toxic responses. The most commonly understood is the Jarisch Herxheimer's reaction. Jarisch Herxheimer reaction (JHR) is a transient clinical phenomenon most notably apparent in patients infected by spirochetes who undergo antibiotic treatment. The reaction occurs within a short period after antibiotic treatment of spirochete infections, including syphilis, leptospirosis, Lyme disease, and relapsing fever. It leads to the release of lipopolysaccharides (LPS).
Lipopolysaccharides (LPS) are large, complex molecules that comprise the outer membrane of gram-negative bacteria, such as E. coli and Salmonella. LPS are biologically identifiable and can trigger an innate immune response. This response is often similar to the adverse effects of a cold or flu.
Chronic infections are often stealth and do not illicit a strong or noticeable "die off" Herxheimer reaction. However, with an effective treatment, the stealth machinery of the stealth infection is compromised, and the immune system sees the offending antigen. It then responds in the same way as for acute infections like those that cause flu or colds.
Our bodies rely on detox pathways to "mop up" the debris formed in the immune response. Various types of immune cells, including macrophages and immunoglobulins, participate in the detoxification pathway.
DETOX
Many systems support detox, including the liver, spleen, kidneys, mucous membranes, sweat glands, respiration, and the lymphatic system (including the spleen). All these systems rely on energy.
Your liver may be your most important detox organ. I'm sure you think your kidney, but your liver converts substances into bioavailable forms and supports detoxification. It does this through the action of enzymes, which rely on micronutrients to carry out the reactions. Thus, micronutrients play a more prominent role in detox compared to macronutrients.
REPAIR
Immunity, Energy (metabolism), and Detoxification pathways create and mitigate debris. What they don't do is repair the damage. In that context, repair could be considered the most important of the four (4) pathways.
We are not pieces of plastic that deteriorate when exposed to the environment. Our bodies are constantly rebuilding tissue. This process occurs in response to use, overuse, and damage. But it is also a natural part of rebuilding as cells and tissue have their own life, being born, functioning, and dying. Below is a charge of the half-lives of tissue under normal conditions of living. Anyone who has hit the gym for the first time in years and gets the "burn" realizes that muscle cells, which are suddenly put under lots of new stress, break down and reform in a way that leads to more resilient cells to anticipate and accommodate the potential of higher ongoing stressors.
Notice a few cases of "old dogma" in this chart. For example, the central nervous system cells are reported to last a lifetime. That is absurd. Retinal cells are part of the nervous system. These cells turn over rapidly. No cell flourishes for 50+ years.
Here is the Mercola article titled,
"Billions Worldwide Face Micronutrient Deficiencies, Study Finds."
Keep in mind that this study only examined "common nutrients." This is just the tip of the iceberg.
Food goes beyond providing energy — it’s essential for proper nutrition. Yet, many people fail to get the essential micronutrients they need. The problem often lies in food quality rather than quantity. People are consuming energy-dense, nutrient-poor foods, setting them up for an excess of omega-6 fats from seed oils as well as added sugars, while missing out on vital micronutrients.
Micronutrient deficiencies are a prevalent form of malnutrition, leading to serious consequences like pregnancy complications, weakened immunity and increased risk of diseases. While past studies have investigated nutrient deficiencies and supplies, there has been no comprehensive global assessment of micronutrient intake inadequacies until now.
A recent study published in The Lancet Global Health1 addresses this gap by evaluating whether current intake levels meet recommended health standards, focusing on deficiencies across different ages and genders. Their findings highlight an alarming trend — over half of the global population is deficient in the necessary micronutrients for optimal health.
Global Study Reveals Alarming Widespread Micronutrient Inadequacies
The study,2 conducted by researchers at Harvard T.H. Chan School of Public Health and the University of California, Santa Barbara (UCSB), used data from 31 countries to model global nutrient needs. They applied these models to a dataset from 185 countries, estimating nutrient deficiencies for 99.3% of the world’s population. Fifteen essential nutrients, including calcium, B vitamins and vitamin C, were evaluated across different age and gender groups.
"Our study is a big step forward," said co-lead author Christopher Free, Ph.D., a research professor at the University of California, Santa Barbara (UCSB), in a news release.3 "Not only because it is the first to estimate inadequate micronutrient intakes for 34 age-sex groups in nearly every country, but also because it makes these methods and results easily accessible to researchers and practitioners." According to the authors:4
"More than 5 billion people do not consume enough iodine (68% of the global population), vitamin E (67%) and calcium (66%). More than 4 billion people do not consume enough iron (65%), riboflavin (55%), folate (54%) and vitamin C (53%).
Within the same country and age groups, estimated inadequate intakes were higher for women than for men for iodine, vitamin B12, iron and selenium and higher for men than for women for magnesium, vitamin B6, zinc, vitamin C, vitamin A, thiamin and niacin."
These results underscore the widespread nature of micronutrient deficiencies globally, revealing distinct patterns related to sex and geographic location. "We hope this analysis … improves understanding of global micronutrient inadequacy so that public health interventions can more effectively address deficiencies," the researchers concluded.
Common Nutrient Deficiencies in the US
According to data from the National Health and Nutrition Examination Surveys (NHANES), an estimated 31% of the U.S. population is at risk of developing one or more micronutrient deficiencies.5 The most common nutrient deficiencies include vitamins D, B1, B2, B3 and B12, A, C, E, calcium, magnesium and iodine.
Although the study didn't include vitamin D since it primarily focused on nutrients obtained through diet, vitamin D deficiency remains a significant concern in the U.S., impacting approximately 35% of the population.6 Vitamin D is a fat-soluble vitamin that is essential for various physiological functions, including calcium absorption, bone health and immune function.
While it’s found naturally in some foods, your body endogenously produces vitamin D when your skin is exposed to ultraviolet rays from the sun.
However, many factors limit this natural production, including living in northern latitudes, having darker skin, spending most time indoors or using sunscreen. Additionally, as people age, their skin becomes less efficient at producing vitamin D from sun exposure.7
The ideal way to increase your vitamin D levels is through sensible sun exposure. On a typical sunny day,8 your body produces up to 25,000 international units IU of vitamin D. However, it's important to approach sun exposure with care, especially if your diet is high in seed oils (rich in linoleic acid, or LA).
These oils migrate to your skin and oxidize when exposed to sunlight, causing inflammation and DNA damage, which makes you more prone to sunburn. If you're on a high-LA diet, I recommend avoiding intense sun exposure until you’ve reduced your seed oil intake for four to six months. As you reduce your LA intake, slowly increase your time outdoors. You’ll eventually be able to enjoy an hour or more during peak sunlight hours.
If you’re unable to get adequate sun exposure, vitamin D3 supplementation is a wise choice. For health and disease prevention, aim for a level between 60 ng/mL and 80 ng/mL. In Europe, the measurements you're looking for are 150 to 200 nmol/L, respectively.
To determine how much vitamin D3 you need to take, measure your vitamin D level, ideally twice a year. Your ideal dose is whatever it takes to keep you within that 60 ng/mL to 80 ng/mL range. It’s also important to remember that calcium, vitamin D3, magnesium and vitamin K2 must be properly balanced, as these four nutrients work together.
Vitamin B1, B2 and B3
Vitamin B1, also known as thiamine, is used by nearly all your cells and is essential for several functions in the body, including energy production, nerve function, heart health, cognition, digestion and immune function.9
While thiamine deficiency is often the result of alcohol misuse, chronic infections, poor nutrition and/or malabsorption, research suggests vitamin B1 availability has dramatically declined throughout the food chain in recent years,10 and that naturally affects your ability to get sufficient thiamine from your diet.
Adult men and women need 1.2 and 1.1 milligrams (mg), respectively, each day.11 If you have symptoms of thiamine deficiency, you might need higher doses. For tips on how to boost your vitamin B1 levels, I recommend reading my article, "Common Signs of Vitamin B1 Deficiency."
Similarly, vitamin B2, commonly known as riboflavin, is important for energy production, cellular function and metabolism. As a coenzyme in various redox reactions, riboflavin is essential for converting food into usable energy. It plays a central role in the electron transport chain, where it helps produce ATP, the primary energy source for the body. This makes riboflavin particularly important for overall energy levels and metabolic health.12,13
To increase your riboflavin levels, consume a diet rich in riboflavin sources. Good dietary sources include grass fed dairy products, lean meats like grass fed beef tenderloin, organic low-PUFA eggs, cremini and portabella mushrooms, and green leafy vegetables like spinach and beet greens.
Vitamin B3 exists in two primary forms — niacin (nicotinic acid) and niacinamide (nicotinamide). Both are essential to human health and play important roles in cellular metabolism, converting the food you eat into energy.
These forms of vitamin B3 also serve as precursors for the coenzymes nicotinamide adenine dinucleotide (NAD+) and nicotinamide adenine dinucleotide phosphate (NADP), which are vital for energy production, DNA repair and cell signaling.
For optimal health, I recommend taking 50 mg of niacinamide three times a day. This dosage has been shown to optimize energy metabolism and boost NAD+ levels.
The problem with taking too much vitamin B3, whether in the form of niacin or niacinamide, is that it might backfire and contribute to cardiovascular disease as demonstrated in a study conducted by the Cleveland Clinic.14
I talked more about this in my article, "Vitamin B3 Boosts Muscle Mass, Improves Glucose Control." As for food sources, vitamin B3 is found in grass fed beef and beef liver, bananas and mushrooms.15
Vitamin B12
Also known as cobalamin, vitamin B12 is a water-soluble vitamin that plays a role in numerous biochemical reactions and neurological functions in your body, including DNA synthesis. Your body can’t make vitamin B12 on its own, so it must be obtained via your diet or supplementation.16
According to NHANES data, about 3.6% of U.S. adults aged 19 and older have a vitamin B12 deficiency, with the rate slightly increasing to 3.7% in those 60 and older. However, vitamin B12 insufficiency is more common, affecting around 12.5% of adults aged 19 and older and 12.3% of those 60 and older. During pregnancy, vitamin B12 levels often decrease, sometimes falling below normal levels.17
Vitamin B12 is found almost exclusively in animal foods, such as grass fed beef and beef liver, lamb, organic eggs and grass fed dairy products. The few plant foods that are sources of B12 are actually B12 analogs that block the uptake of true B12, so do not make the mistake of thinking you can rely on vegan sources for all your B12 needs.
If you rarely eat the foods listed, consider using nutritional yeast. It’s high in B12 and has a cheesy flavor that works well on any number of dishes. One 16-gram serving (just over 2 tablespoons) provides 24 micrograms of natural vitamin B12.18 Advancing age diminishes your body’s ability to absorb B12 from food, so you might want to consider supplementation as you get older.19
Vitamins A and C
An estimated 51% of adults are not consuming enough vitamin A,20 increasing their risk of degenerative diseases like macular degeneration, a leading cause of blindness in the U.S.21 Vitamin A is also responsible for immune system function as well as cellular growth and differentiation.22
Vitamin A is a group of nutrients that falls into two different categories — retinoids found in animal foods and carotenoids found in plant foods. The two are chemically different and provide different health benefits, but both are necessary for optimal health. Plant foods high in beta-carotene include sweet potatoes, carrots, cantaloupe and mangoes. Animal foods rich in vitamin A include liver, egg yolks and grass fed butter.23
Vitamin C, also known as ascorbic acid, is known for its potent antioxidant properties and role in numerous bodily functions, including tissue growth and repair, collagen synthesis, iron absorption and immune function.24
A wide variety of foods are high in vitamin C, including red pepper, parsley, broccoli, kiwi, strawberries, guava, tomato and all citrus fruits. You’ll get significant amounts of vitamin C from your diet if you eat these foods on a daily basis.
In addition to dietary sources, I highly recommend keeping liposomal vitamin C in your medicine cabinet, particularly for acute viral illnesses. If I were to become acutely ill, I would take 4 grams of liposomal vitamin C every hour until feeling better, then start decreasing the dosage slowly over a few days once symptoms improve.
Vitamin E
Vitamin E is a fat-soluble vitamin with potent antioxidant properties, protecting your cells from free radical damage. It also supports the production of red blood cells, regulates your body's use of vitamin K (which is important for heart health) and is involved in your immune function and cell signaling.25 Additionally, it protects your body against damage caused by linoleic acid and estrogen.
In the U.S. alone, approximately 88.5% of the population fails to reach the recommended dietary allowance (RDA) of vitamin E.26 To increase vitamin E levels, eat foods rich in this nutrient, including spinach, pumpkin, asparagus, red bell peppers, tomatoes, kiwi and mango.27
Some health authorities recommend vegetable oils, seeds and nuts as good sources,28 but these are actually terrible due to their high LA content. Beans — another good source of vitamin E — are also problematic for many due to their high lectin content.
Supplementation is also an option to increase your levels, but it’s important to look for a real vitamin E supplement and not synthetic. What you’re looking for is "d alpha tocopherol." I go into detail about this in "Vitamin E Helps Decrease Your Cancer Risk."
Calcium and Magnesium
Over 40% of the U.S. population fails to meet their calcium needs through diet alone, putting them at increased risk of bone-related issues such as osteoporosis and fractures.29 Calcium is also essential for muscle contraction, nerve transmission and blood clotting.30
A deficiency in calcium coupled with excess phosphorus intake due to phosphate additives in processed food poses additional risk, as it disrupts your calcium-to-phosphorus ratio, which leads to calcification of the vascular system and cardiovascular problems.31
Some good dietary sources of calcium to increase your levels include grass fed dairy products like yogurt, milk and cheese made from animal rennet. Some vegetables contain this mineral as well, such as collard greens, spinach, turnip greens, kale, cooked taro root and bok choy.32
Estimates suggest that over half of the U.S. population also aren’t getting enough magnesium from their diet.33 While the minimum amount needed to avoid deficiency is about 150 to 180 milligrams per day, optimal levels are closer to 600 milligrams per day. For reference, the RDA ranges from 310 to 420 milligrams per day, depending on age and sex.34
Some good dietary sources of magnesium include dark chocolate, leafy greens, potatoes (peeled and boiled) and plain organic yogurt, to name a few. Avocados are also commonly recommended as a good source of this mineral, but they’re high in monounsaturated fat (MUFAs), which harms your metabolic function if consumed in excess.
Iodine
Iodine is an essential trace mineral that plays a role in the production of thyroid hormones, which regulate metabolism, growth and development. Adequate iodine intake is vital for maintaining healthy thyroid function and reducing the risk of disorders such as goiter and hypothyroidism. In addition, iodine is important for healthy bone and brain development during pregnancy and infancy.35
Foods that contain higher amounts of iodine include sea vegetables, such as kelp, kombu and wakame.36 Kelp has the highest amount of any food and just one serving gives you four times the recommended daily allowance. Organic, grass fed butter is another good source of iodine. Iodized salt also increases your levels if you don’t avoid eating it in the mistaken belief that it’s bad for your heart.
Will Taking a Multivitamin Help with Nutrient Deficiencies?
A diet rich in whole, nutrient-dense foods is key to avoiding nutrient deficiency. However, multivitamins help address gaps if you’re not eating right or if you suspect you have deficiencies. Research37 from Oregon State University found that older men who took multivitamins showed improved nutritional biomarkers compared to those who took a placebo.
In fact, some participants in the placebo group had decreased nutrition markers, indicating that diet alone might not be sufficient, particularly for maintaining vitamin and carotenoid levels.38 Multivitamins also benefit memory in older adults. One study39 found that daily use could improve memory performance comparable to reversing about three years of age-related decline compared to a placebo.
If you’re planning to take multivitamins, it’s generally recommended to take half your daily dose in the morning, with breakfast, and the other half with your main meal. Remember, though, that multivitamins should complement, not replace, a healthy diet.
Dietary supplements are meant to support a balanced lifestyle, not substitute for it. Consider consulting with a holistic health professional to identify specific nutrient deficiencies and tailor your supplement and food choices to address them.
Sources and References
1, 2, 4 Lancet Glob Health. 2024 Aug 29:S2214-109X(24)00276-6
5 The Institute of Functional Medicine, The Hidden Hunger: Micronutrient Deficiencies
8 Journal of Steroid Biochemistry and Molecular Biology, 2019;189
13 StatPearls [Internet]. Biochemistry, Oxidative Phosphorylation
15 Harvard T.H. Chan School of Public Health, Niacin – Vitamin B3
17 Harvard T.H. Chan School of Public Health, Riboflavin — Vitamin B2
19 The New York Times, Vitamin B12 as Protection for the Aging Brain
20 Oregon State University, Micronutrient Inadequacies, Vitamin A
25, 28 NIH ODS, Vitamin E
29 Oregon State University, Micronutrient Inadequacies in the US Population: an Overview
32 Dietary Guidelines for Americans, Food Sources of Calcium
33 Oregon State University, Micronutrient Inadequacies (Magnesium)
35, 36 NIH ODS, Iodine
39 The American Journal of Clinical Nutrition July 2023, Volume 118, Issue 1, Pages 273-282, Results
This is my first formal blog on this topic although I have been discussing this topic for over a decade - starting with a video I created called "The Genesis of Health."
When you are hungry, you lack calories, right? Or could this be just part of the story? Please give your brain more credit than this simplified "one-for-one," that is hunger equals a need for calories.
Your car engine thirsts for calories (aka gasoline). But will it operate long-term without oil, coolant, transmission fluid, tires, axles, and all the other components that make it a car?
What is the difference between YOU and a car or a piece of plastic that, when exposed to air and sunlight, turns brittle and turns to dust. We also have repair pathways. Indeed, calories drive the engine to facilitate repair, but our micronutrient status carries out the daily and laborious task of rebuilding our bodies.
Do you know why your poop is brown? One reason is that you are constantly shedding red blood cells. In this process, your kidneys extract the iron for reuse, and the cell color without iron is BROWN. Bile and bilirubin, which are yellow, also contribute to the appearance of brown.
What is the point? Your stool reminds you daily that your body is renewing.
Insulin resistance is a sign of malnutrition. Here is a short video explaining this.
This is a summary of the video. Consider 3 people.
Professional cyclist who consumes 1.5 pounds of sugar daily for at least 100 days each year.
An obese person who appears quite healthy
An obese person who is obviously unhealthy and impaired.
What are the similarities: High calorie intake!
What are the differences? Persons 1 and 2 take in high levels of micronutrients, while person 3 is on a SAD fast food diet with very low levels of micronutrients.
The logic that the fasting insulin value is a measure of micronutrient malnutrition is straightforward.
A lack of calories drives hunger. Only a minority of people in the developed world lack adequate caloric intake. Also, “silent hunger,” or a deficiency in micronutrients, causes a hunger response. People with silent hunger include a substantial population in the developed and undeveloped world. However, it is especially prevalent in the developed world, which mostly consumes "corporate" (processed) foods.
"Silent hunger means a deficiency of nutrients that affects billions of people worldwide. When wanting to eradicate hunger, it's not only about the calories – the vitamins, the minerals, and antioxidants are important, too."
Here are some references. The IFM calls this epidemic "Hidden Hunger."
Here is the sequence:
An individual starts with complete insulin sensitivity – metabolically, he or she is in homeostasis.
The Standard American Diet (SAD) or equivalent high carbohydrate diet with processed foods, which are both low in micronutrients, is consumed.
When more calories are consumed than required, the excess is stored in the body as fat. However, low-value food causes micronutrient deficiency and silent hunger, driving the desire for more food.
As low-value food is constantly consumed, silent hunger perpetuates. If not curbed, this process leads to a downward spiral into insulin resistance, weight gain, obesity, and an eventual diagnosis of diabetes.
This process also leads to a myriad of chronic conditions because the body cannot rebuild tissue to match or exceed the rate of deterioration.
Fasting insulin is a valuable biomarker because it is a barometer for malnutrition and early mortality risk. The two, of course, are related. Malnutrition is somewhat complicated to measure, whereas data on the relationship between fasting insulin and premature mortality statistics are readily available in peer-reviewed journal articles.
A strong relationship exists between fasting insulin and all-cause mortality. Figure 5.1 shows the risk, which rises rapidly for Insulin levels above 6.4 mU/l. Mortality data below six (<6) is not easy to find and may be confounded by type 1 diabetes in some instances, but the absolute optimal insulin level is between 1.5 and 3 mU/l.
This is from my book, "Health Freedom Lost."
Risk expressed by many biomarkers follows a “U” curve. When a biomarker or vital sign is too low, the risk of dying prematurely increases. For a biomarker elevated above normal, this is also the case. Insulin is no exception
According to Lee, “Both type 1 and type 2 diabetes are well-established risk factors for cardiovascular death and early all-cause mortality. People with type 1 diabetes (T1D) have a three- to four-fold increased risk of premature death compared with the general population. T1D is also associated with an increased risk of cardiovascular disease (CVD), including myocardial infarction (MI), heart failure (H.F.), and atrial fibrillation (A.F.).
Low serum insulin level is associated with all‐cause mortality and cardiovascular mortality in acutely decompensated heart failure patients without diabetes mellitus.”
In COVID-19, insulin resistance and supplemental insulin correlated to a higher risk of death than those who did not use insulin. The increase in mortality reported was severe, 260 percent higher compared to people not on exogenous insulin therapy. ,
Importantly, in this study, the people on insulin therapy and those who were insulin-sensitive were not compared. Instead, they were compared to those just not on insulin. In other words, they were compared to people, many of whom had insulin resistance. Therefore, compared to insulin-sensitive people, the mortality risk is much higher than 260 percent.
I have had a fasting insulin level of 1.3 before. I know healthy middle-aged athletes who developed Type 1 diabetes. Thus, in my case, I ran a C-peptide test. Here is why a C-peptide test might be considered in anyone with a fasting insulin below 1.5.
C-peptide is also useful in evaluating residual beta-cell function in insulin-dependent diabetics, many of whom have antibodies that interfere with insulin assays. Glucagon-stimulated C-peptide concentration has been shown to be a good discriminator between insulin-requiring and non−insulin-requiring diabetic patients. The diagnosis of islet cell tumor is supported by elevation of C-peptide when plasma glucose is low.
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