Comprehensive Health Analysis
Follow-Up 21
prepared for
Female Demo
by provider
Joseph Raffaele, MD
based on tests performed
2 April 2020
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Table of Contents

Introduction

The information we have gathered will enable you to better control your health. By measuring how well you're aging in important body systems, we give you a personalized view of your overall health and identify your weakest and strongest systems.

We compare your measurements to our database of hundreds of patients, each with multiple visits. We use this data, along with statistical modeling, to calculate your physiological age. Three main factors affect your physiological age: actual age, rate of aging, and functional capacity. On average, the aging process diminishes functional capacity by 1 to 3 percent per year. If you start off at a higher capacity, you start falling from a higher point (for instance, if you're genetically endowed, or if your lifestyle, diet or medication improves it.) The rate at which you fall depends on similar factors. In order to understand what is happening at any particular point or over time, you need to measure that system's function objectively.

Does that mean that I'm aging like a 57-year-old even though I'm 45?

You can't determine your rate of aging from one test, which is just a snapshot. In order to know your rate of aging, you must have at least two separate time points, generally a year apart, to calculate the rate of change in that system.

Now that you have more than one set of biomarkers, we can begin to capture your rate of aging and understand how your body is changing over time. Each subsequent set of biomarkers increases our ability to accurately assess your rate of aging. The diagrams that follow are a variation of the chart that appeared in your baseline report. The vertical axis represents the physiological age of each system, while the horizontal axis shows your measurements over time. Each dot marks the physiological age during that biomarker session, while the slope of the line shows your rate of aging. The thicker shaded gray line represents your actual age and will always have an upward slope because it increases with time.

If the slope of your physiological age line is steeper than that of your actual age line, your system is aging more rapidly than average. In contrast, if the slope is less steep, it's aging more slowly than average; if it's running parallel, it's not aging at all. Finally, if the slope is declining, this system is actually functioning better - it's getting more youthful! As in the baseline diagrams, any point above the actual age line indicates an older physiological age, and anything below indicates a younger physiological age.

You may notice that for some of your biomarkers, the line is wavy, with fluctuations up and down. This occurs because there is an inherent variability in these measurements that can sometimes be greater than the actual change in the body system. Your physician will also point out changes in medications that can cause more extreme changes, such as the dramatic change certain blood pressure medications can cause to CardioAge. Over time, however, these fluctuations become less important, and the trend in your physiological age becomes more solid.

Report Card

B-
Arterial Stiffness
B-
Cardiovascular Risk
A
Diabetes & Glucose
D
Muscle and fat
A
Bone Density
A+
Skin Elasticity
D+
Lung Health
F
Vitamins
C
Trace Essential Minerals
B
Major Essential Minerals
B
Kidney Function
A-
Liver Function
B-
Advanced Immune Health
C+
Telomere Length

Biomarkers of Aging

PhysioAge Composite

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 204060 Highcharts.com

Your PhysioAge is 31, 27 years younger than than average for your age

Sometimes we can become too focused on the trees and lose sight of the forest. So this composite score tells how well you are aging across many systems.

That's important because some treatments benefit one system but cause adverse effects in another. For example, high intensity exercise can improve your arterial and pulmonary systems. But too-intense exercise can age your immune system. Some therapies, such as telomerase activators, subtly but profoundly affect all organ systems.

EpiGenAge

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 204060 Highcharts.com

Your EpiGenAge is 50, 8 years younger than than average for your age

CardioAge

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 204060 Highcharts.com

Your CardioAge is 46, 12 years younger than than average for your age

It's all in the pulse. Today we know that what Mr. Sydenham said holds true for women as well. Even before him, Chinese doctors knew that you could tell a lot about the age of a person's cardiovascular system just by feeling the pulse at the wrist.

The human pulse is a product of the cardiac cycle - the rhythmical filling of the chambers of the heart with blood from the veins, called diastole, and the subsequent ejection of the blood into the arteries, called systole.

As the heart pumps out a large amount of blood, the elastic aorta expands to accept the increased volume causing the pressure to increase less than if it were a rigid tube. The pressure wave then travels down the aorta to the legs and arms where it meets the smaller arteries feeding the capillary beds of your organs. The drop in pressure at these resistance arteries causes a reflected wave to return to the aorta.

Arteries stiffen and constrict with age.

The aorta and other large arteries stiffen from a loss of elastin and cross-linking of collagen. This stiffening causes the reflected wave to travel back to the heart faster so that it rushes into the last bit of blood coming out of the heart in the aorta at the end of systole. The increased central pressure as a result of the collision of the forward and reflected waves occurs in the aorta but not in the arms, and is called the augmentation pressure (AP). The amount of augmentation pressure is dependent not only on the speed of the reflected wave, but also on how much resistance the forward wave meets when it hits the smaller vessels. Thus, the AP combines the two major facets of arterial aging - stiffening of the large arteries and constriction of the resistance arteries - into a single value that increases linearly with age.

Your CardioAge is created by comparing your AP with that of thousands of healthy (no other cardiac risk factors), men and women aged 18 to 90 years old.

  • Age: It takes time for all of the following risk factors to affect your arteries.
  • Sedentary vs. active lifestyle: Activity, in particular vigorous exercise, increases the production of nitric oxide in your small arteries, which decreases AP. Chronic aerobic exercise lowers your resting heart rate, which decreases the total number of times your heart beats in a day.
  • Height: Taller people have lower central pressures because the reflected wave takes longer to travel back up the aorta to the heart.
  • Gender: Women have slightly stiffer arteries than men, even after adjusting for height. Your CardioAge is gender-adjusted.
  • Smoking: After having a cigarette, even in young people, AP is increased because it causes constriction of the resistance arteries. Despite this increase in central pressure, arm blood pressure often remains deceptively low in young smokers. With years of smoking, the large arteries stiffen more rapidly and the smaller arteries become clogged - both of these processes increase your CardioAge.
  • Obesity: Increased abdominal fat (central obesity) has been associated with increased arterial stiffness independent of arm blood pressure, age, and ethnic group.
  • Cholesterol: High total and LDL cholesterol levels have been associated with increased arterial stiffness. Thus, cholesterol lowering medications can lower your CardioAge.
  • Caffeine: Consumption of caffeinated coffee has been associated with increased AP, even after one cup, without a similar increase in arm blood pressure. If you had a cup of a caffeinated drink within 2 hours of your test, your CardioAge could be somewhat higher.
  • Hormones: Low testosterone increases AP in men undergoing androgen deprivation therapy. Growth hormone deficiency is associated with increased arterial stiffness.
  • Blood pressure medications: The more recent blood pressure medications, such ACE inhibitiors, angiotensin receptor blockers, and calcium channel blockers, lower your augmentation pressure and therefore your CardioAge. Beta blockers, such as atenolol, propranolol, and metoprolol can actually increase your CardioAge. Diuretics often have a neutral effect. If you are on any of these medications at the time of your test, you must tell you doctor so that your results can be interpreted correctly.

The SphygmoCor device looks like a standard blood pressure cuff but detects the pressure caused by the wave of blood pumped out by your heart. The pressure in the aorta is different from that in the arm (where blood pressure is traditionally measured) because of the effect of what is called the "reflected wave". The software analyzes the shape of the pressure wave within the arm cuff to determine the pressure in the aorta as it comes off the heart.

The arterial pulse wave shape offers information about the health of the arterial system as blood moves through it during the pulsatile cardiac cycle.

PulmoAge

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 0204060 Highcharts.com

Your PulmoAge is 20, 38 years younger than than average for your age

Breathing tests are typically used to assess and monitor symptoms of asthma and emphysema patients. These symptoms include coughing, wheezing, and shortness of breath. If you've never had any of these symptoms, you are unlikely ever to have taken such a test. But some experts now recommend this test for everyone over 20. It is quick, inexpensive and can screen for the existence of otherwise invisible lung disease that can gradually develop in those exposed to passive smoke, asbestos, and other environmental toxins.

From screening to lung age. Spirometry (from the Latin word spirare, to breathe) turns out to be an informative biomarker of aging. Spirometry performed by tens of thousands of individuals has resulted in large databases which shows a strong correlation between results and age, once adjusted for height, gender and ethnicity.

The Buffalo Health Study followed nearly 1,200 men and women between the ages of 20 and 89 for twenty-seven years. It found that lower lung function predicted earlier death.

The correlation between lung health and mortality is not solely based on respiratory diseases. Studies show that decreased spirometry results result in an increased risk of all kinds of deaths. These findings bolster the idea that respiratory function over time reflects how well the body as a whole is aging, making spirometry one of the most valuable biomarkers of aging.

We consider FEV1 as a surrogate for a number of unmeasured aging processes ... and not as a specific measure of lung function.

Dr. Milton Hollenberg San Francisco Medical Center

Many of the same factors that affect your CardioAge affect your PulmoAge. The most significant factors:

Toxins - Cigarette smoke, asbestos, and other toxins will decrease your score.

Lung Structure - Differences in the structure of your chest, barrel vs. narrow, can also affect it.

Medications - Asthma or emphysema inhaled medications such as bronchodilators and anti-inflammatories can improve your FEV1 and FVC, so your physician needs to know if you are taking one in order to accurately interpret your results.

ImmunoAge

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 204060 Highcharts.com

Your ImmunoAge is 44, 14 years younger than than average for your age

Older adults are more likely to succumb to infections than their younger selves. Cancer rates increase exponentially with age. Dysfunctional immune cells cause chronic inflammation, which increases the likelihood of degenerative diseases such as osteoporosis, atherosclerosis, and dementia.

One of the most prominent changes in immune function as we age is a decrease in naive suppressor cells. These cells are designed to target a specific anitgen. If they detect it, they will multiply rapidly to mount a vigorous defense. As humans age, these cells become less prevalent in the blood until, around our ninth decade, we have nearly a complete absence of the ability to fight off new infections and tumors. It is no coincidence that the average life expectancy falls around that age.

CutoAge

Why do I need a fancy instrument to tell me how well my skin is aging?

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 0204060 Highcharts.com

Your CutoAge is 20, 38 years younger than than average for your age

Intrinsic vs. extrinsic skin aging. Most people think that just looking in the mirror ought to suffice, yet studies have demonstrated that facial skin appearance is more affected by the amount of sun exposure (photoaging) than it is by the passage of time. As such, your skin's appearance is not a great biomarker of aging. However, intrinsic skin aging (the loss of elasticity and fine wrinkling that occur in areas of your body that receive relatively little sun exposure), correlates very closely with age. This linear change in elasticity is hard to appreciate with the naked eye until it is relatively advanced.

Skin elasticity, while an accurate and interesting biomarker, is not the most significant metric in terms of health.

To measure intrinsic skin aging we use the Cutometer, an instrument that has been validated in hundreds of studies of skin aging over the past 25 years. It works by applying a sequence of precise and gentle suctions to a small area of skin and then measuring with an optical sensor how much the top two layers of your skin move with each suction. The movement is very slight - only 0.2-0.5 mm - much less than the amount it moves when you do a "pinch test" to see how fast your skin returns to normal after pinching it between your two fingers. Yet by involving only the top two layers, the Cutometer can non-invasively assess the amount and structure of the collagen and elastin in your skin.

A typical adolescent has a skin elasticity around 90%. With each passing year, the average person loses about 1%. A typical 80-year-old will have around 35% elasticity.

TelomerAge

Created with Highcharts 6.2.0 Values Chart title Series 1 Series 2 Baseline 2 years 4 years 6 years 8 years 10 years 12 years 14 years 16 years 18 years 20 years 204060 Highcharts.com

Your TelomerAge is 53, 5 years younger than than average for your age

Your molecular "ends" of time.

If there is a candidate to be considered the human body's molecular clock, then one of the front runners must certainly be the length of our telomeres. From the Greek, telos, meaning 'end,' and mere, meaning 'part,' telomeres are the caps on the ends of each of our chromosomes that protect them from being mistaken for damaged DNA. They are composed of thousands of repetitions of the same sequence of 6 base pairs (the letters of DNA, TTAGGG). With each cell division, they shorten by about 50-100 base pairs because of the difficulty DNA polymerase has replicating one of the strands. At young adulthood, the mean lymphocyte telomere length (MTL) is about 8 kb (8,000 kilo base pairs). Once it reaches 4 kb, the cell no longer is able to divide and enters what is called 'replicative senescence,' in which it fails to perform its function and produces detrimental inflammatory molecules. The molecular clock stops ticking.

How are telomeres measured? The subset of your white blood cells used to calculate your ImmunoAge, the lymphocytes, is the cell type whose telomere length has been most studied. This is mostly because of its easy access through a routine blood draw, as opposed to a biopsy of solid tissue such as your lungs or arteries. Hundreds of studies have linked the shortening of lymphocyte MTL not only to the aging process, but also to cardiovascular disease, smoking, various cancers, and even psychological stress. (A few studies have measured the correlations between MTL and the telomere lengths of other tissues in the body and have found general agreement.)

The average person's lymphocyte MTL decreases about 30-50 base pairs per year; you are more likely to be in the higher end of this range if you smoke, don't exercise, have a lot of stress, or have a chronic disease. Thus, if you start out with a lymphocyte MTL of 8 kb and lose 0.04 kb/yr (40 base pairs), you will get to the critical length of 4 kb in 66 years, again, very close to the average human lifespan.

  • Telomere length is predictive of mortality when corrected for age.

  • Telomere length is associated with risk for osteoporosis, diabetes, cardiovascular disease, dementia and cancer.

You may be thinking, "If your telomere length functions as such a great biomarker of aging and disease, why don't we just measure it instead of bothering with all these other tests?"

First, mortality can be caused by a failure in any major system. But also, while telomere length correlates with age very well, the combination of biomarkers correlates much better, confirming the age-old notion that the whole is more than the sum of its parts.

  • Genetic inheritance. In addition to the rate of loss, each of us inherits about 50% of our telomere length at birth from our parents.

  • Psychological stress. Studies have shown that chronic emotional stress, such as being the caregiver to an Alzheimer's patient, can increase one's rate of telomere loss.

  • Oxidative stress. Chronic increased inflammation can shorten telomeres, in addition to the effect of continuous cell division.

  • Antigenic stress. When your lymphocytes are chronically stimulated to divide in response to latent infections (particularly viral infections such as HIV or CMV) or tumors, their telomeres shorten more rapidly.

Comparing Systems

This bar chart shows the most current ages of your overall PhysioAge Composite and the physiological systems we measured to calculate it. Your PhysioAge Composite is a weighted average of the other underlying ages.

A bar pointing up indicates that this particular physiological system is older, or weaker than average for your age. A bar pointing down indicates it is younger, or stronger than average for patients your age. Each of us has a different combination of weaker and stronger systems depending on genetic inheritance and lifestyle factors/therapeutic interventions.

Health Status Indicators

Arterial Stiffness

Grade Name Result Units Normal Range Optimal Range Baseline Change
B
SubEndocardial Viability Ratio 190

%

186 - 240

220-350

-
C
Aortic Pulse Pressure 40

mm Hg

26 - 46

<25

31
B
Aortic Systolic Blood Pressure 100

mm Hg

98 - 125

70-93

118
A
Systolic Blood Pressure (at rest) 100

mm Hg

90 - 120

70-110

116
A
Diastolic Blood Pressure (at rest) 70

mm Hg

60 - 80

65-75

79
B
Resting Heart Rate 55

bpm

50 - 99

33-55

67
C
Augmentation Pressure 10

mm Hg

5 - 12

<2

12
D
Augmentation Index @ 75 35

%

17 - 38

<8

34

As arteries stiffen, the heart must work harder to get blood to the body. As your heart contracts, it generates a pulse that travels through the circulatory system. The pressure and volume of this pulse directly affect the wear on your organs. As arterial stiffness increases, it has several negative effects:

Stiffness results in increased pulse pressure, causing greater wear on sensitive tissues in the arteries, kidney, and brain. The increased pressure happens for two reasons. First, healthy arteries naturally smooth out the flow of blood that is forcefully ejected from the heart. As your arteries stiffen, this dampening effect is diminished. Second, the heart must pump with greater pressure to get blood through the stiffened arteries.

Also, an increase in arterial stiffness increases the work the heart needs to do to maintain the volume of blood needed by the body. This can lead to increased heart rate and subsequently may reduce the absorption of nutrients and oxygen from the blood.

Why is arterial stiffness important?

Various measures of arterial stiffness in the large arteries have been shown to predict the likelihood of future cardiovascular events such as heart attacks and strokes. These data of arterial stiffness have been shown to be better predictors than other commonly measured parameters such as upper arm blood pressure.

What factors affect arterial stiffness?

Arteries naturally harden as we age. Genetic predisposition, diet and exercise seem to be the primary determinants of how rapidly this process occurs.

Consistant exercise will help to prevent arteries from becoming stiffer, and can help to increase compliance of stiff arteries. Also, some blood pressure medicines reduce arterial stiffness by relaxing the muscles in the wall of the artery.

SubEndocardial Viability Ratio

SubEndocardial Viability Ratio is a measure of the ability of the heart to fill the coronary arteries (at a given heart rate) so that sufficient nutrients and oxygen can get to the inner lining of the heart muscle (the subendocardium). When this ratio drops below 130, angina can occur. A level above 220 is a measure of a healthy heart and vascular system.


Aortic Pulse Pressure

Aortic Pulse Pressure is the difference between the ASBP and aortic diastolic blood pressure.  This is similar to the AP used to calculate your CardioAge.  If you are over 40 years old, your ASBP is greater than 121 mm Hg, and your APP is greater than 45 mm Hg, then you should consider talking to your doctor about starting lifestyle and diet modification to lower your ASBP.  If these are not successful, then blood-pressure lowering medications such as an ACE inhibitor, calcium channel blocker, or ARB should be considered.   In contrast, it doesn’t matter what your SBP is if your ASBP is below 120 mm Hg.  Many young men with muscular arms have SBPs greater than 130, but have very low central pressures because of the amplification of blood pressure that occurs in the peripheral circulation.  These are the newest recommendations for diagnosing and managing hypertension using central blood pressures to avoid treating individuals who won’t benefit and to pick up those who will but would be missed by conventional arm cuff blood pressure measurements.


Aortic Systolic Blood Pressure

Aortic Systolic Blood Pressure is the peak blood pressure experienced by the aorta during systole.  In many studies, it has proven to be a much better predictor of cardiovascular disease risk than arm SBP.   


Systolic Blood Pressure (at rest)

Systolic Blood Pressure is the peak blood pressure reached during systole, the part of the cardiac cycle during which the heart contracts and squeezes blood into the peripheral circulation. SBP increases with age and predicts strokes and heart attacks in many studies. However, it is not as good a predictor of cardiovascular disease nor your rate of aging as Augmentation Pressure (AP).


Diastolic Blood Pressure (at rest)

Diastolic Blood Pressure is the time during the cardiac cycle that the heart muscle is relaxing and filling up with blood. It is often misunderstood to continue to rise with age, when in fact, it reaches a peak in mid-adulthood and then starts to decline because of the decrease in elastic recoil of the aorta and muscular arteries. A decline in DBP in an older adult accompanied by an increase in SBP increases rather than decreases the risk of cardiovascular disease.


Resting Heart Rate

Resting Heart Rate is the number of times your heart beats per minute. It has been shown to be a good low-tech marker for cardiovascular disease risk. Several studies have shown that resting heart rate predicts cardiovascular mortality, with the risk decreasing in line with heart rate (assuming the absence of other pathologies that produce the same low resting heart rate)


Augmentation Pressure


Augmentation Index @ 75

Augmentation Index @ 75 is the AP corrected for the difference between systolic and diastolic blood pressure, called the 'Pulse Pressure,' and heart rate. In younger patients, it may be a slightly better indicator of cardiovascular age than AP. However, in older patients, it is less useful because it plateaus by age 65.


Cardiovascular Risk

Grade Name Result Units Normal Range Optimal Range Baseline Change
A
Total Cholesterol 140

mg/dL

125 - 200

125-175

-
C
HDL Cholesterol 47

mg/dL

>46

>60

-
B
LDL Cholesterol 114

mg/dL

<129

60-100

-
B-
Triglycerides 130

mg/dL

<149

<50

-
C
Cholesterol/HDL Ratio 4.0

Ratio

<5.0

<3.0

-
LDL/HDL Ratio 2.4

Ratio

-

Heart disease is the leading killer of Americans. That's tragic because, after years of study, the medical community has a solid understanding of this disease and a plethora of treatment options. We can often completely mitigate these diseases and their consequences. The results listed here will help you and your physician determine your risk and what strategies you can take to mitigate or minimize that risk.

Heart disease claims the lives of about one in five Americans. Abnormal values in this section should be taken seriously. They are strongly indicative of your risk of a stroke, cardiovascular disease, atrial fibrillation, diabetes, hypertension and more.

What factors determine my risk of heart disease?

The results below have been shown to be accurate predictors of cardiovascular risk by the famous Framingham Heart Study. This gold-standard study has been ongoing since 1948. It involved an initial 5,209 men and women. It now includes their children, grandchildren, and others. The resulting data has allowed physicians to discover what makes heart disease tick.

Total Cholesterol

Total Cholesterol is made up of the LDL, HDL, and TG. A normal cholesterol level is below 200 mg/dL, but ideally it should be below 150. However, the relative amounts of the LDL and HDL affect how "dangerous" a given total cholesterol level is. For example, if your total cholesterol is 230, and your HDL is 70, you are in a less risky range than if your total cholesterol is 190 and your HDL is 30. This is because the LDL accompanying the first of these profiles would likely be significantly lower than that of the second.


HDL Cholesterol


LDL Cholesterol

LDL Cholesterol is known as the "bad" cholesterol because it can become oxidized by free radicals and initiate atherosclerosis as discussed above. All things being equal, the lower the LDL the better. A level below 130 mg/dL is normal, and above 160 mg/dL confers a significant increase risk of CVD. When the total cholesterol is 150 mg/dL, the LDL is usually about 80 mg/dL. Nutritional anthropologists have speculated that this is the average human level of LDL when we consumed the natural diet of our ancestral environment.


Triglycerides

Triglycerides are the three- (hence the "tri") chain fatty acid lipoproteins which are increased significantly immediately after a meal, but circulate in lower levels in the fasting state. Levels above 150 mg/dL are associated with an increased risk of CVD, but can also be the result of inflammation of the pancreas. You must be fasting for 8 hours for the TG level to be interpretable. This because the type of food you ate just prior to a test can have a great impact on the level and not be representative of the average TG level. For example, if you had high-fat meal prior to the test, your TG could be twice as high as if you had an average or low-fat meal.


Cholesterol/HDL Ratio


Diabetes & Glucose

Grade Name Result Units Normal Range Optimal Range Baseline Change
A
Hemoglobin A1C 4.0

%

<6.0

<5.2

5.5
A
Estimated Average Glucose 68.1

mg/dL

111.2
A
Glucose 75

mg/dL

65 - 99

<89

106

Diabetes is the disorder in which your blood sugar (glucose) is not maintained within the normal range, which leads to complications such as cardiovascular and kidney disease, retinopathy, neuropathy, and ultimately premature death. There are two forms of diabetes.

TYPE I comprises 5% of cases, occurs in childhood or adolescence (juvenile diabetes), and is an autoimmune disorder in which the insulin-producing cells of the pancreas are destroyed. The destruction progresses fairly rapidly and results in an insufficient or complete lack of insulin, which can lead to extremely high blood glucose and diabetic coma.

Type II comprise 95% of cases, usually begins in adulthood and the risk increases with age. In contrast to Type I, it is a disorder of insulin resistance and only late in its natural history is there a decrease in insulin production. There is a gradual onset that is usually coincident with decreased physical activity and body fat accumulation. A prediabetes state of "glucose intolerance" often occurs months to years before. Similar to cholesterol, blood glucose level has a continuous range from frank disease to optimal. These biomarkers of blood sugar control allow us to tell you how well you are processing glucose.

Hemoglobin A1C

Hemoglobin A1C is also known as 'glycosylated' or 'glycated' hemoglobin. Hemoglobin is the protein in your red blood cells that carries oxygen. As your red blood cells circulate, they are exposed to the glucose in your blood plasma. Over time, the glucose molecules can attach to the hemoglobin which then becomes glycated hemoglobin. The percentage of glycated hemoglobin in your red blood cells depends on the amount of time the red blood cells circulate and the concentration of glucose to which they are exposed. Because the average life span of a red blood cell is 4 months approximately, the percentage of them containing glycated hemoglobin serves as an excellent measure of the average blood glucose level over the past 4 months. HgbA1c is a subset of the general category called advanced glycation end-products which go by the very descriptive acronym AGEs. (The more AGEs you have, the faster you age.) These are any biomolecules (proteins, etc.) that have undergone a reaction in which a glucose molecule becomes permanently attached. Once this happens, the proteins do not function well and unfortunately, unlike with red blood cells, they are often not removed from the body for a very long time. This leads to suboptimal function of the tissue. Lower levels of AGEs production lead to better maintenance of youthful tissue function.


Glucose


Muscle and fat

Grade Name Result Units Normal Range Optimal Range Baseline Change
Height 55

inches

64
D
Weight 74.0

lbs

184.5
B
Body Mass Index 16.8

kg/m2

31.7
Fat Mass 80.0

lbs

70.8
Lean Body Mass 82.0

lbs

104
F
Percent Bodyfat 108.1

%

30.7
Skeletal Muscle Mass 90.0

lbs

56.2
Total Body Water 78.0

lbs

74.7
Intracellular Water 2

lbs

46.5
Extracellular Water 76.0

lbs

29.8
Extracellular / Total Body Water 0.974

0.378
D
Basal Metabolic Rate 77

kCal/day

>2000

1390

The InBody multi-polar bioimpedance spectrometry device assesses body composition by applying varying frequencies of a low level current to all four limbs of the body. By doing so, it is able to measure much more accurately overall lean body mass (LBM) than a device that utilizes a single frequency and applies it only to the legs. Then, by subtracting the LBM from the total body weight, overall fat mass and percentage can be calculated.

Weight

Weight is less useful as a measure of health except: * when compared with past values; a significant change in weight can be indicative of mental or physical disease. * When indexed on gender and height; it can be compared with normal values. Other metrics, such as those in the Body Composition section, are a much better measure of health.


Basal Metabolic Rate


Bone Density

Grade Name Result Units Normal Range Optimal Range Baseline Change
AP Spine L1-L4 T-Score 1.0

-1.0 - 1.0

-
AP Spine L1-L4 BMD 1.000

g/cm2

1.000 - 1.000

-
A
Dualfemur Neck Mean T-Score 1.5

<2.0

>0.0

-
A
Dualfemur Troch Mean T-Score 1.5

<2.0

>0.0

-
Dualfemur Total Mean BMD 1.000

g/cm2

1.000 - 1.000

-
Dualfemur Neck Mean T-Score


Dualfemur Troch Mean T-Score


Skin Elasticity

Grade Name Result Units Normal Range Optimal Range Baseline Change
A+
Skin Elasticity 96

%

84

Skin elasticity, as measured by Cutometer using the PhysioAge protocol, is a measure of your skin's ability to stretch in response to being pulled and then how close to its original state it can return after applying multiple strains. This is expressed as a percentage where 95% is about the maximum because human skin is not 100% elastic.

Because it is measured on the underside of the forearm, it is consider unsunexposed and therefore a measure of instrinsic skin aging, the kind that would take place even if you never exposed your skin to sun.

Lung Health

Grade Name Result Units Normal Range Optimal Range Baseline Change
Forced Vital Capacity 7.333

L

3.443
D
FVC Percent Predicted 45

%

99
Forced Exhaled Volume in 1 seconds 8.333

L

-
C
FEV1 Percent Predicted 75

%

-
FEV1/FVC 114

%

-
Respiratory Rate 55

breaths / min

-

As mentioned in the PulmoAge section, FEV1 is a powerful biomarker of aging hiding in the guise of a lung disease test. But both the forced expiratory volume (FEV1) and the forced vital capacity (FVC) tests you took are also important screening tests for lung disease.

Screen for potential lung disease: If your FEV1/FVC is less than 0.70 then you may have some element of obstructive pulmonary disease like asthma, bronchitis, or COPD. Your provider will ask you to repeat the test if the value is abnormal. From that point, you may move on to more extensive tests or be referred to a pulmonary specialist.

If your FVC is below the normal range for your age, then you may have some element of restrictive lung disease such as emphysema or pulmonary fibrosis.

Sex Hormones

Grade Name Result Units Normal Range Optimal Range Baseline Change
Last Menstrual Period Start Date 56

-
Pregnenolone 50.00

ng/dL

13.00 - 111.00

-

Vitamins

Grade Name Result Units Normal Range Optimal Range Baseline Change
F
Skin Antioxidant Score 96

>50000

-

Vitamins are essential cofactors in many of the important reactions in your body. They varying structures and belong to different classes of molecules so they shouldn’t be lumped together when talking about research showing their effectiveness. Many studies demonstrates that there are ranges of blood levels of indiviyvitamjns that are associated with disease, lower quality health , and optimal function.

Skin Antioxidant Score


Trace Essential Minerals

Grade Name Result Units Normal Range Optimal Range Baseline Change
C
Iron 45

µg/dL

40 - 160

50-100

-
D
Transferrin Saturation 14

%

-
B
Total Iron Binding Capacity 320

µg/dL

250 - 450

-

are so named because they are found in much smaller amounts in your body than the major essential minerals. But maintaining optimal levels of them is necessary of healthy aging. The nine trace minerals are chromium, copper, fluoride, iodine, iron, manganese, molybdenum, selenium, and zinc (in alphabetical order). There are many others that have important roles in the body as well, such as vanadium. Other trace minerals can have deleterious effects when found in higher concentrations, e.g., lead, mercury, and arsenic.

Iron

Iron is an essential nutrient for the production of red blood cells and many enzyme-dependent reactions. While iron deficiency can cause anemia and fatigue, an excess of iron can increase free-radical production and increase the risk of cancer and cardiovascular disease. As with many nutrients, an optimal level is needed for good health - too much or too little can cause harm. The serum iron level can fluctuate quite significantly depending on recent dietary iron intake. A better indicator of iron deficiency is the transferrin saturation.


Total Iron Binding Capacity

Total Iron Binding Capacity is the amount of the iron binding protein called "transferrin" in the blood stream. It is usually increased in iron deficiency and decreased in conditions of excess iron.


Major Essential Minerals

Grade Name Result Units Normal Range Optimal Range Baseline Change
C
Sodium 145

mmol/L

135 - 146

141
Potassium 5.0

mmol/L

3.5 - 5.3

4.0-4.4

-
B
Chloride 108

mmol/L

98 - 110

101-106

-
A
Carbon Dioxide 25

mmol/L

21 - 33

24-28

-
A
Calcium 9.2

mg/dL

8.6 - 10.2

9.0-9.8

-
B+
Magnesium In Serum 1.9

mg/dL

1.5 - 2.5

-
Magnesium in Red Blood Cells 5.00

mg/dL

4.00 - 6.40

-
B
Phosphorus 3.0

mg/dL

2.5 - 4.5

2.5-2.9

-

Your major essential minerals are comprised of your electrolytes and other minerals that circulate in your bloodstream in relatively high concentrations and perform essential functions.

Electrolytes are the positively and negatively charged small molecules (called 'ions') found in your cells, blood stream, and extracellular fluids. They are maintained in a delicate balance by your kidney, lungs, and endocrine system. They are critical in the electrical signaling between and within cells, the acid-base balance (pH), and the maintenance of the fluid balance between different body compartments. Small fluctuations in their relative levels can be clues to serious disease processes. Cations and anions (negatively and positively charged ions) travel together as salts to balance the overall charge of a fluid. They are usually measured together in a serum sample because interpretation of one requires knowledge of the levels of most of the others.

Sodium

Sodium is the principal positively charged ion (called a "cation") of the extracellular space. It is the same as the sodium found in most foods and table salt (sodium chloride). The body responds to changes in the serum sodium level in three main ways: (1) Modulating thirst: as little as a 1% increase in serum sodium can make you thirsty so you consume water to decrease the level to normal. (2) Producing sodium-regulating hormones: certain hormones (natriuretic peptide) cause the kidneys to lose sodium while others (aldosterone) cause them to retain sodium. (3) Producing water-regulating hormones: antidiuretic hormone (ADH) causes the kidneys to hold onto free water. Water follows sodium. When you eat a salty meal, you become thirsty and drink water. The extra fluid is retained (causing the characteristic post-Chinese food bloating and edema) until it can be excreted as the hormonal sodium excretion pathways kick in. ADH is inhibited by alcohol causing the excessive urination of clear water noted after drinking a lot of beer or other alcoholic beverages. When these mechanisms are not functioning well or are overwhelmed, a state of hypernatremia (high serum sodium) or hyponatremia (low serum sodium) can ensue. The most common cause of hypernatremia is dehydration from decreased water intake. Hyponatremia is most commonly from sodium loss through sweat that is replaced only with water. Other causes include diuretics, Addison's disease, diarrhea, and kidney disease.


Potassium

Potassium is the principal intracellular cation, and only about 2% of your total body potassium is located in your body fluids and blood stream. Increased serum potassium (hyperkalemia) is most commonly caused by kidney disease, but other medications, such as ACE inhibitors, potassium-sparing diuretics, and NSAIDs, can cause it. Hyperkalemia can cause abnormal heart rhythms and respiratory failure. Low serum potassium (hypokalemia) can be caused by dehydration, vomiting, diarrhea, and inadequate repletion when taking diuretics.


Chloride

Chloride is the anion that travels with sodium in and out of cells to help regulate body fluids and acid-base balance. When a problem arises with the serum sodium level, the chloride can diverge from sodium to buffer the pH of the blood temporarily. Chloride is ingested as sodium chloride in food and table salt. Increased chloride levels most commonly indicate dehydration, and a decreased level can be caused by vomiting, chronic lung disease or with a loss of acid from the body.


Carbon Dioxide

Carbon Dioxide should really be called bicarbonate or HCO3 because CO2 is actually the gas that your lungs exhale. When it is dissolved in water, CO2 is associates with a hydrogen ion to become HCO3 and acts as a buffer for acid in the blood. A low serum bicarbonate level indicates that your body is in an acidic state and the bicarbonate is being used up to buffer it. This can be caused by diabetes, kidney disease, and chronic diarrhea. A high bicarbonate level indicates alkaline pH of the blood due to acid loss from vomiting, lung disease, or Cushing's syndrome. While it is technically not a mineral but a molecule, it is one of the electrolytes so it is included in this section.


Calcium

Calcium is a mineral cation in your blood that is essential for the healthy functioning of your muscles, nervous system, and heart. Its serum concentration is very tightly regulated by your kidneys and endocrine system because deviations from the normal level can have serious consequences. If there is a mild elevation (less than 10.5), the first thing to do is to repeat the blood test to make sure it is not a lab error. Persistently high serum calcium (hypercalcemia) is commonly caused by either hyperparathyroidism (benign tumors of the parathyroid gland secreting too much parathyroid hormone) or cancer that has spread to the bones. Low serum calcium is most commonly caused by a low serum protein level (from malnutrition) because the calcium is bound to protein. A follow-up ionized serum calcium level will be normal if this is the only cause. Other causes of hypocalcemia are low vitamin D level, underactive parathyroids (hypoparathyroidism), magnesium deficiency, and kidney failure.


Magnesium In Serum

Magnesium In Serum plays a vital part on many levels in the human body. On the cellular level, it participates in protein creation, cellular energy production and a host of other important functions (it is estimated that magnesium is present in more than 300 reactions throughout the body). At a higher level, it can affect everything from nerve transmission to blood pressure. Unfortunately, the process for testing magnesium can be less than accurate, especially if the patient has not fasted, or has diabetes or other diseases. Good food sources of magnesium include unrefined grains, spinach, nuts, legumes, and white potatoes (tubers.)


Phosphorus

Phosphorus is a mineral which forms phosphates when combined with oxygen. The bonds between the phosphorus and oxygen in phosphates contain energy which is used in many chemical reactions in the body. Only a very small amount (1%) of your total body phosphate circulates in your blood. The rest is incorporated into bones, teeth, and muscle or is found in the rest of the cells of the body in energy storage molecules. An abnormal level of phosphorus normally does not cause any symptoms. However, it can indicate a problem with the parathyroid hormone or vitamin D and can help to interpret the cause of low or high calcium. Low phosphorus can be associated with hypercalcemia, hypothyroidism, out-of-control diabetes, and diuretic abuse. High phosphorus can be associated with kidney disease and excess phosphate intake.


Kidney Function

Grade Name Result Units Normal Range Optimal Range Baseline Change
C
Creatinine 1.00

mg/dL

0.50 - 1.20

0.50-0.80

0.98
B
Urea Nitrogen in Blood 15

mg/dL

7 - 25

16
B
BUN/Creatinine Ratio 20.00

Ratio

6.00 - 22.00

10.00-20.00

16
A
Uric Acid 5.0

mg/dL

2.5 - 7.0

2.5-6.0

6.4
Creatinine

Creatinine is a product of the breakdown of creatine, compound produced by your muscles when they are actively contracting. Because creatinine is produced at a relatively constant rate and is excreted almost exclusively by your kidneys, its serum level is a good indicator of kidney filtration rate (health). However, an increased serum level can be found in people with higher muscle mass or who have been exercising vigorously prior to the test. Cystatin C is a newer measure of kidney function that is not affected by these factors. Low levels of creatinine are usually found in people with relatively low muscle mass and higher levels can indicate kidney function decline. A level above 2 is usually an indication that some impairment of kidney function is present. In most individuals, creatinine slowly increases (0.5-1% per year) with age, making it a biomarker of kidney function aging.


Urea Nitrogen in Blood

Urea Nitrogen in Blood is produced when your body breaks nitrogen-containing protein down into its constituent amino acids and the liver combines the nitrogen into the waste product urea. There is a relatively constant production of BUN, which the kidneys then filter out and excrete into the urine. Diseases that affect the kidneys or the liver can raise BUN. Other causes include heart failure, dehydration, and or gastrointestinal bleeding. Low BUN is not very common and if present is usually not a cause for concern. The most common cause of an elevated BUN in an otherwise healthy individual is mild dehydration.


BUN/Creatinine Ratio

BUN/Creatinine Ratio is used to differentiate dehydration or excess BUN production from kidney problems. In kidney failure, both creatinine and BUN rise, so the ratio will not increase. When there is excess BUN production only (from, e.g., gastrointestinal bleeding) you will see an increased BUN/Creatinine. A mildly elevated ratio (22-25) can occur in people with low muscle mass (which causes a low creatinine level) and slight dehydration, but is usually not a cause for concern.


Uric Acid

Uric Acid is a product of the breakdown of one type of nucleic acid (a component of DNA/RNA) called a purine. The serum uric acid level can rise when there is excessive production or decreased excretion via the kidneys and feces. Excess production can occur during chemotherapy/radiation (breakdown of cells with release of DNA) and decreased excretion because of kidney disease. Some people have an inherited condition in which they produce a higher level of uric acid and are at risk for kidney stones and gout (the painful inflammation of joints caused by the presence of uric acid crystals in the joint space). Like bilirubin, uric acid is also a potent antioxidant and people with a level in the upper range of normal may have better protection from free-radical damage.


Liver Function

Grade Name Result Units Normal Range Optimal Range Baseline Change
B
Albumin 3.9

g/dL

3.6 - 5.1

>4.5

-
A
Protein 7.3

g/dL

6.2 - 8.3

6.0-8.0

-
A
Aspartate Aminotransferase 15

IU/L

10 - 35

<20

-
A
Alkaline Phosphatase 34

IU/L

33 - 130

0-40

-
Lactate Dehydrogenase 125

IU/L

120 - 250

152-218

-

The tests usually grouped under the heading of 'liver function tests' impart a variety of information, not all about just the liver. They can be divided into 3 categories: synthetic function, liver/bile duct damage, and immune system function.

Albumin

Albumin is the most abundant protein in human serum. It is important for maintaining normal osmotic pressure (the force keeping the fluid in the blood vessels), carrying certain hormones, and neutralizing free radicals. It is produced in the liver, and a decreased level can indicate reduced liver function or liver disease. The serum level of albumin decreases with age even in the absence of disease. An increased level is generally the result of dehydration. In the absence of dehydration, a higher serum level is generally a sign of good health.


Protein

Protein is the sum of the albumin and globulin proteins in the serum.


Aspartate Aminotransferase

Aspartate Aminotransferase is an enzyme similar to ALT except it transfers the amino group of aspartate. It is used as an indicator of liver and cardiac muscle damage. When both ALT and AST are elevated, there is an increased risk of liver damage. The ratio of AST to ALT can be used to distinguish among causes of aminotransferase elevations. An AST/ALT < 2 is often indicative of chronic liver disease from Wilson's disease and alcoholic liver disease. An AST/ALT < 1 is indicative of acute liver disease or that caused by fatty deposits in the liver, as occur in obesity and diabetes.


Alkaline Phosphatase

Alkaline Phosphatase is an enzyme that takes phosphate groups off of molecules and works best in an alkaline (high pH) environment. It is present throughout the body, but particularly in liver, bile duct, and bones. The level of alkaline phosphatase is measured as a biomarker for damage to one of the organ system where it is produced. Alkaline phosphatase serum level can be elevated when the bile duct is blocked or inflamed. A healing fracture can cause an increase in alkaline phosphatase. Low levels of alkaline phosphatase can be associated with low thyroid function, but for the most part, a level lower than the low end of normal is of no clinical significance.


Lactate Dehydrogenase


Advanced Immune Health

Grade Name Result Units Normal Range Optimal Range Baseline Change
A
T Cell Ratio 2

Ratio

-
B
NK Cells 100

cells/µL

51 - 543

150-250

-
C
NK Cell % 24

%

3 - 26

8-14

-
B
B-Cells 100

cells/µL

74 - 447

-
B
B-Cell % 20

%

5 - 22

-
B
Helper T-Cells 500

cells/µL

467 - 1350

>900

-
B
Helper T-Cell % 35

%

32 - 59

45-55

-
Suppressor T-Cells 250

cells/µL

201 - 868

-
Suppressor T-Cell % 35

%

13 - 38

-
Healthy Suppressor T-Cells 188

cells/µL

-
B
Healthy Suppressor T-Cell % 75

%

-
C
Senescent Suppressor Cells 200.00

cells/µL

17.00 - 364.00

<50.00

-
C
Senescent Suppressor Cell % 25

%

4 - 51

<10

-
B
Naive Suppressor Cells 130.0

cells/µL

32.0 - 347.0

>250.0

-
A
Naive Suppressor Cell % 40

%

11 - 57

>35

-

Lymphocytes are the next most abundant white blood cell in the bloodstream and can be divided into subsets that have specific functions and characteristic changes with age and disease states. The table above depicts the important lymphocyte subsets that we assessed.

Many cells of the body are identified by molecule markers that protrude out of ("are expressed on" in biology lingo) their cell membranes. These molecules enable the cell to communicate with other cells and receive instructions from signaling molecules, such as those that direct them to a site of infection. Lymphocytes can be subdivided by these 'cluster designation' or 'CD' markers into Natural Killer (NK) cells, B-cells, and T-cells, etc.

NK Cells

NK Cells carry the CD56 and CD16 proteins on their surface. They are part of the innate immune system because they do not have a T-cell receptor and can kill virally infected and certain tumor cells. Recent research has demonstrated that they are deeply involved with the adaptive immune system. In healthy adults, the function of individual NK-cells decreases with age, but as for neutrophils, their number increases to compensate.


NK Cell %


B-Cells

B-Cells are designated by expression of the CD19 marker and are derived from the bone marrow. They are the part of the adaptive immune system that produces antibodies that travel in the bloodstream looking for the antigens found on the surface of pathogens. Through a complex process of DNA rearrangement during maturation, each B-cell produces only one type of antibody. However, the large number of B-cells produced by a healthy young immune system enables it to recognize virtually any new pathogen that may invade the body. When an antibody encounters its unique antigen, it initiates a process that results in the invader's destruction. Unfortunately, the number of B-cells decreases linearly with age, which may be one of the reasons older adults are more susceptible to bacterial infections and cancer.


B-Cell %


Helper T-Cells

Helper T-Cells help to orchestrate the functions of other WBCs by releasing cytokines (attracting and stimulating molecules) or by binding to them. They don't actually kill infectious agents or tumor cells (they are not cytotoxic) by themselves but rather recruit other cells to do so. They do not significantly decrease in number with age.


Helper T-Cell %


Senescent Suppressor Cells

Senescent Suppressor Cells are suppressor cells that have undergone multiple rounds of cell division, often in response to chronic viral infections. They are no longer able to divide but do not die; far from being inert, they secrete inflammatory cytokines that can damage tissues. In older adults, they can comprise over 50% of the circulating suppressor cells. It is the increase in their number that is usually the cause of the decrease in the CD4/CD8 ratio which defines the major component of the immune risk profile.


Senescent Suppressor Cell %


Naive Suppressor Cells

Naive Suppressor Cells are designated by lack of expression of the CD95 molecule with is involved in apoptosis. They are known as "virgin T-cells" because they have not encountered the antigen for their TCR and can be thought of as the reservoir of cells able to fight off new infections and tumors. They reach a peak of up to 50% of suppressor cells in young adulthood, but gradually decline as the thymus involutes. By the ninth decade, they can circulate in the single digits.


Naive Suppressor Cell %


Telomere Length

Grade Name Result Units Normal Range Optimal Range Baseline Change
C
Granulocyte Telomere Length 6.0

kb

5.5 - 10.0

>8.5

-
B
Lymphocyte Telomere Length 7.0

kb

4.5 - 9.0

>8.0

-

As discussed in the TelomerAge section, the mean lymphocyte telomere length is a potent biomarker of aging. Although it is measured in lymphocytes, is reflects telomere attrition in other tissues as well.

Granulocyte Telomere Length

Granulocyte Telomere Length is measured in the very short-lived neutrophils, eosinophils, and basophils (hours to a few days lifespan). Because these cells do not continuously divide after being released into the bloodstream, the GTL reflects very well the telomere length of the hematopoietic progenitor cell residing in the bone marrow. This reflects the genetically determined component of your telomere length. As a result, the GTL is almost always longer than the LTL. The GTL-LTL gap (the difference between the lengths of each) is an even better (than LTL) measure of the chronic stress affecting your immune system from latent infections and also inflammatory diseases such as atherosclerosis.


Lymphocyte Telomere Length

Lymphocyte Telomere Length is measured in all the circulating lymphocytes, including B-cells, T-cells, and NK-cells. The majority consists of T-cells which can exist in the peripheral circulation and lymph nodes for years, dividing when necessary to combat infection. Therefore, the lymphocyte telomere length is a good marker for the amount of time and degree of chronic stimulation to which your immune system has been subjected from pathogens.


EpiGenAge

Grade Name Result Units Normal Range Optimal Range Baseline Change
DNAge Zymo 50.0

years

-
DNAge Monitor 50

years

-

Exceptional Results

Name Result Units Normal Range Optimal Range Baseline Change

Arterial Stiffness

Systolic Blood Pressure (at rest) 100 mm Hg 90 - 120 70-110
Diastolic Blood Pressure (at rest) 70 mm Hg 60 - 80 65-75

Cardiovascular Risk

Total Cholesterol 140 mg/dL 125 - 200 125-175

Diabetes & Glucose

Hemoglobin A1C 4 % <6.0 <5.2
Estimated Average Glucose 68.1 mg/dL
Glucose 75 mg/dL 65 - 99 <89

Bone Density

Dualfemur Neck Mean T-Score 1.5 <2.0 >0.0
Dualfemur Troch Mean T-Score 1.5 <2.0 >0.0

Skin Elasticity

Skin Elasticity 96 %

Major Essential Minerals

Carbon Dioxide 25 mmol/L 21 - 33 24-28
Calcium 9.2 mg/dL 8.6 - 10.2 9.0-9.8

Kidney Function

Uric Acid 5 mg/dL 2.5 - 7.0 2.5-6.0

Liver Function

Protein 7.3 g/dL 6.2 - 8.3 6.0-8.0
Aspartate Aminotransferase 15 IU/L 10 - 35 <20
Alkaline Phosphatase 34 IU/L 33 - 130 0-40

Advanced Immune Health

T Cell Ratio 2 Ratio
Naive Suppressor Cell % 40 % 11 - 57 >35

Abnormal Results

Name Result Units Normal Range Optimal Range Baseline Change

Arterial Stiffness

Augmentation Index @ 75 35 % 17 - 38 <8 34 3%

Cardiovascular Risk

LDL/HDL Ratio 2.4 Ratio

Muscle and fat

Height 55 inches
Weight 74 lbs
Fat Mass 80 lbs 70.8 13%
Lean Body Mass 82 lbs 104 -21%
Percent Bodyfat 108.1 %
Skeletal Muscle Mass 90 lbs
Total Body Water 78 lbs
Intracellular Water 2 lbs
Extracellular Water 76 lbs
Extracellular / Total Body Water 0.974
Basal Metabolic Rate 77 kCal/day >2000 1390 -94%

Bone Density

AP Spine L1-L4 T-Score 1 -1.0 - 1.0
AP Spine L1-L4 BMD 1 g/cm2 1.000 - 1.000
Dualfemur Total Mean BMD 1 g/cm2 1.000 - 1.000

Lung Health

Forced Vital Capacity 7.333 L
FVC Percent Predicted 45 %
Forced Exhaled Volume in 1 seconds 8.333 L
FEV1/FVC 114 %
Respiratory Rate 55 breaths / min

Sex Hormones

Last Menstrual Period Start Date 56
Pregnenolone 50 ng/dL 13.00 - 111.00

Vitamins

Skin Antioxidant Score 96 >50000

Trace Essential Minerals

Transferrin Saturation 14 %

Major Essential Minerals

Potassium 5 mmol/L 3.5 - 5.3 4.0-4.4
Magnesium in Red Blood Cells 5 mg/dL 4.00 - 6.40

Liver Function

Lactate Dehydrogenase 125 IU/L 120 - 250 152-218

Advanced Immune Health

Suppressor T-Cells 250 cells/µL 201 - 868
Suppressor T-Cell % 35 % 13 - 38
Healthy Suppressor T-Cells 188 cells/µL

EpiGenAge

DNAge Zymo 50 years
DNAge Monitor 50 years

Complete Data

Grade Name Result Units Normal Range Optimal Range Baseline Change

Arterial Stiffness

B
SubEndocardial Viability Ratio 190 % 186 - 240 220-350
C
Aortic Pulse Pressure 40 mm Hg 26 - 46 <25 31 29%
B
Aortic Systolic Blood Pressure 100 mm Hg 98 - 125 70-93 118 -15%
A
Systolic Blood Pressure (at rest) 100 mm Hg 90 - 120 70-110
A
Diastolic Blood Pressure (at rest) 70 mm Hg 60 - 80 65-75
B
Resting Heart Rate 55 bpm 50 - 99 33-55
C
Augmentation Pressure 10 mm Hg 5 - 12 <2 12 -17%
D
Augmentation Index @ 75 35 % 17 - 38 <8 34 3%

Cardiovascular Risk

A
Total Cholesterol 140 mg/dL 125 - 200 125-175
C
HDL Cholesterol 47 mg/dL >46 >60
B
LDL Cholesterol 114 mg/dL <129 60-100
B-
Triglycerides 130 mg/dL <149 <50
C
Cholesterol/HDL Ratio 4 Ratio <5.0 <3.0
LDL/HDL Ratio 2.4 Ratio

Diabetes & Glucose

A
Hemoglobin A1C 4 % <6.0 <5.2
A
Estimated Average Glucose 68.1 mg/dL
A
Glucose 75 mg/dL 65 - 99 <89

Muscle and fat

Height 55 inches
D
Weight 74 lbs
B
Body Mass Index 16.8 kg/m2
Fat Mass 80 lbs 70.8 13%
Lean Body Mass 82 lbs 104 -21%
Percent Bodyfat 108.1 %
Skeletal Muscle Mass 90 lbs
Total Body Water 78 lbs
Intracellular Water 2 lbs
Extracellular Water 76 lbs
Extracellular / Total Body Water 0.974
D
Basal Metabolic Rate 77 kCal/day >2000 1390 -94%

Bone Density

AP Spine L1-L4 T-Score 1 -1.0 - 1.0
AP Spine L1-L4 BMD 1 g/cm2 1.000 - 1.000
A
Dualfemur Neck Mean T-Score 1.5 <2.0 >0.0
A
Dualfemur Troch Mean T-Score 1.5 <2.0 >0.0
Dualfemur Total Mean BMD 1 g/cm2 1.000 - 1.000

Skin Elasticity

A+
Skin Elasticity 96 %

Lung Health

Forced Vital Capacity 7.333 L
D
FVC Percent Predicted 45 %
Forced Exhaled Volume in 1 seconds 8.333 L
C
FEV1 Percent Predicted 75 %
FEV1/FVC 114 %
Respiratory Rate 55 breaths / min

Sex Hormones

Last Menstrual Period Start Date 56
Pregnenolone 50 ng/dL 13.00 - 111.00

Vitamins

Skin Antioxidant Score 96 >50000

Trace Essential Minerals

C
Iron 45 µg/dL 40 - 160 50-100
D
Transferrin Saturation 14 %
B
Total Iron Binding Capacity 320 µg/dL 250 - 450

Major Essential Minerals

C
Sodium 145 mmol/L 135 - 146
Potassium 5 mmol/L 3.5 - 5.3 4.0-4.4
B
Chloride 108 mmol/L 98 - 110 101-106
A
Carbon Dioxide 25 mmol/L 21 - 33 24-28
A
Calcium 9.2 mg/dL 8.6 - 10.2 9.0-9.8
B+
Magnesium In Serum 1.9 mg/dL 1.5 - 2.5
Magnesium in Red Blood Cells 5 mg/dL 4.00 - 6.40
B
Phosphorus 3 mg/dL 2.5 - 4.5 2.5-2.9

Kidney Function

C
Creatinine 1 mg/dL 0.50 - 1.20 0.50-0.80
B
Urea Nitrogen in Blood 15 mg/dL 7 - 25
B
BUN/Creatinine Ratio 20 Ratio 6.00 - 22.00 10.00-20.00
A
Uric Acid 5 mg/dL 2.5 - 7.0 2.5-6.0

Liver Function

B
Albumin 3.9 g/dL 3.6 - 5.1 >4.5
A
Protein 7.3 g/dL 6.2 - 8.3 6.0-8.0
A
Aspartate Aminotransferase 15 IU/L 10 - 35 <20
A
Alkaline Phosphatase 34 IU/L 33 - 130 0-40
Lactate Dehydrogenase 125 IU/L 120 - 250 152-218

Advanced Immune Health

A
T Cell Ratio 2 Ratio
B
NK Cells 100 cells/µL 51 - 543 150-250
C
NK Cell % 24 % 3 - 26 8-14
B
B-Cells 100 cells/µL 74 - 447
B
B-Cell % 20 % 5 - 22
B
Helper T-Cells 500 cells/µL 467 - 1350 >900
B
Helper T-Cell % 35 % 32 - 59 45-55
Suppressor T-Cells 250 cells/µL 201 - 868
Suppressor T-Cell % 35 % 13 - 38
Healthy Suppressor T-Cells 188 cells/µL
B
Healthy Suppressor T-Cell % 75 %
C
Senescent Suppressor Cells 200 cells/µL 17.00 - 364.00 <50.00
C
Senescent Suppressor Cell % 25 % 4 - 51 <10
B
Naive Suppressor Cells 130 cells/µL 32.0 - 347.0 >250.0
A
Naive Suppressor Cell % 40 % 11 - 57 >35

Telomere Length

C
Granulocyte Telomere Length 6 kb 5.5 - 10.0 >8.5
B
Lymphocyte Telomere Length 7 kb 4.5 - 9.0 >8.0

EpiGenAge

DNAge Zymo 50 years
DNAge Monitor 50 years

Historical Data

Name Result Visit Date

Arterial Stiffness

Name Result Visit Date
Anti-hypertensive NO 03/29/2007
Patient Had Caffeine Within Last 6 Hours NONONO 03/29/200705/21/200910/27/2010
SubEndocardial Viability Ratio 190 04/02/2020
Aortic Pulse Pressure 3128293040 03/29/200705/21/200910/27/201007/21/201404/02/2020
Aortic Systolic Blood Pressure 11810897107100 03/29/200705/21/200910/27/201007/21/201404/02/2020
Systolic Blood Pressure (at rest) 116107114119100 05/21/200910/27/201002/04/201311/12/201404/02/2020
Diastolic Blood Pressure (at rest) 796770 05/21/200910/27/201004/02/2020
Resting Heart Rate 6774717355 05/21/200910/27/201002/04/201311/12/201404/02/2020
Augmentation Pressure 1266910 03/29/200705/21/200910/27/201007/21/201404/02/2020
Augmentation Index @ 75 3417182535 03/29/200705/21/200910/27/201007/21/201404/02/2020

Cardiovascular Risk

Name Result Visit Date
Total Cholesterol 140 04/02/2020
HDL Cholesterol 47 04/02/2020
LDL Cholesterol 114 04/02/2020
Triglycerides 130 04/02/2020
Cholesterol/HDL Ratio 4.0 04/02/2020
LDL/HDL Ratio 2.4 04/02/2020

Diabetes & Glucose

Name Result Visit Date
Hemoglobin A1C 5.54.0 11/12/201404/02/2020
Estimated Average Glucose 111.268.1 11/12/201404/02/2020
Glucose 1069610675 04/28/201602/07/201712/12/201804/02/2020

Muscle and fat

Name Result Visit Date
Height 6464646455 05/21/200910/27/201002/04/201311/12/201404/02/2020
Weight 184.5153.0152.6158.274.0 05/21/200910/27/201002/04/201311/12/201404/02/2020
Body Mass Index 31.726.326.227.216.8 05/21/200910/27/201002/04/201311/12/201404/02/2020
Fat Mass 70.869.047.050.746.356.280.0 03/29/200709/21/200710/27/201002/04/201307/21/201411/12/201404/02/2020
Lean Body Mass 104.0107.6106.0101.998.8102.182.0 03/29/200709/21/200710/27/201002/04/201307/21/201411/12/201404/02/2020
Percent Bodyfat 30.733.235.5108.1 10/27/201002/04/201311/12/201404/02/2020
Visceral Fat Level 12 11/12/2014
Skeletal Muscle Mass 56.290.0 11/12/201404/02/2020
Total Body Water 74.778.0 11/12/201404/02/2020
Intracellular Water 46.52 11/12/201404/02/2020
Extracellular Water 29.830.028.728.276.0 09/21/200710/27/201002/04/201311/12/201404/02/2020
Extracellular / Total Body Water 0.3780.974 11/12/201404/02/2020
Basal Metabolic Rate 13901424140913671337137177 03/29/200709/21/200710/27/201002/04/201307/21/201411/12/201404/02/2020

Bone Density

Name Result Visit Date
AP Spine L1-L4 T-Score 1.0 04/02/2020
AP Spine L1-L4 BMD 1.000 04/02/2020
Dualfemur Neck Mean T-Score 1.5 04/02/2020
Dualfemur Troch Mean T-Score 1.5 04/02/2020
Dualfemur Total Mean BMD 1.000 04/02/2020

Skin Elasticity

Name Result Visit Date
Skin Elasticity 8496 11/12/201404/02/2020

Lung Health

Name Result Visit Date
Forced Vital Capacity 3.4437.333 07/21/201404/02/2020
FVC Percent Predicted 9945 07/21/201404/02/2020
Forced Exhaled Volume in 1 seconds 8.333 04/02/2020
FEV1 Percent Predicted 75 04/02/2020
FEV1/FVC 114 04/02/2020
Respiratory Rate 55 04/02/2020

Sex Hormones

Name Result Visit Date
Last Menstrual Period Start Date 56 04/02/2020
Follicle Stimulating Hormone 23.0