You Can’t Improve What You Don’t Measure: Individual Biomarker

Female dietician prescribing nutritional supplement for patient in the consultation.

Measurement is the first step that leads first to understanding, then to control, and eventually to improvement. If you can measure something, you can understand it. If you can understand it, you can control it. If you can control it, you can improve it. You can’t manage for improvement if you don’t measure to see what is getting better (or worse).

Sorting through the vast number of health assessments that are now available can be a daunting task. But they can be grouped into three, basic categories–global health assessments, individual biomarkers, and deeper diagnostic tests.  

Last week I shared with you key global health assessments including the serum chemistry blood calculator, gut microbiome, advanced genetic assessments and urinary metabolic markers that will allow you to get not only a broad view of your individual health needs but a much deeper understanding of the areas of physiological health that you need to address.

This week I want to highlight the next step.

Individual Markers of Health

Cellular Nutrient Status  

While most serum-based tests for nutrient deficiencies measure metabolites, the number of nutrients found in the blood, a company called Spectracell offers a one-of-a-kind assessment that determines your body’s actual, intracellular requirements for vitamins, minerals, amino acids, and antioxidants. It also offers a Spectrox Score—a unique measurement of your body’s total, cellular antioxidant capacity.  The information obtained from this assessment will allow you to determine your body’s cellular need for supplemental nutrients. Restoring your nutrient status can lead to greatly improved energy, immunity, and recovery. While the human body depends on a variety of key nutrients to function fully and efficiently, those listed below are the most important for women to identify and optimize:


Iron is an essential nutrient because it’s required to produce heme, a key component of the hemoglobin found in red blood cells. Hemoglobin is what binds and carries oxygen from the lungs to the muscles. If your hemoglobin level is low, your muscles won’t receive as much oxygen and your health and performance will suffer. In addition, iron is fundamental to the efficiency of many other physical systems. It’s necessary for good bone and tissue health, and it serves as a catalyst for the production of aerobic energy.

Low iron levels are a world-wide health concern that’s becoming increasingly common among children and teens, those who follow a vegan or vegetarian diet, and menstruating women.  Endurance athletes (especially runners) are also prime candidates for iron deficiency. The causes and signs of low iron are many which I have discussed in a previous post.

It is important to understand the difference between a low iron level and anemia. Low iron levels are a detriment to optimum health and performance. They are considered problematic for anyone because they negatively affect the body’s ability to oxygenate itself properly. Anemia, on the other hand, is a disease. The medial diagnosis of anemia indicates that the body’s iron status has become depleted enough to cause an illness with symptoms that often include low blood pressure and a rapid heart rate. Many performance-related problems can be traced to a low iron level in the absence of anemia. In addition, most medical professionals don’t assess ferritin—the marker indicating how much iron the body is actually storing for its functional use.  

FE medical abbreviation meaning total iron or ferrum in blood in laboratory diagnostics on red background. Chemical name of FE is surrounded by medical laboratory test tubes with blood, stethoscopeAs with many other minerals, a cursory check of your serum iron level is not an accurate indicator of your body’s actual tissue stores. Just as you can be very low on gas before the low fuel light goes on, serum levels of minerals like iron will not change until the body’s tissue stores are extremely low. By measuring your ferritin stores, you’ll know exactly how much ‘gas’ you have in the tank; you won’t need to wait for any warning lights to go on.  

While iron deficiency is a much more common concern, high levels of iron—is a condition seen more commonly in men, who tend to eat more red meat (and calories in general) than women and do not menstruate. Ingesting too much iron from dietary supplements (many multivitamins contain iron), processed foods (which are iron-enriched), and a genetic predisposition also contribute to excessive iron levels.  

At even moderately elevated levels, excessive iron can cause inflammation and free radical damage, both of which dramatically increase the risk of cancer, arthritis, and heart disease. Very high levels of iron can cause liver damage, diabetes, and vascular disease.


The importance of magnesium for health and performance has been thoroughly studied, and the results are clear:  You need it for optimal health and performance. Magnesium prevents muscle spasms, assists in energy production, aids in muscular recovery, and helps build lean muscle. In addition, the most recent research shows that a low level magnesium level will interfere with the activity of vitamin D3.

Since magnesium is not produced by the body, it needs to be sourced daily from magnesium-rich foods including leafy greens, nuts, and seeds. Magnesium deficiency is quite common as dietary surveys indicate more than 70 percent of the general population doesn’t consume enough magnesium. Magnesium deficiency is especially common among those eat lots of processed, packaged foods which are devoid of this vital mineral. And yet is very rarely assessed.

There is not one great serum marker of magnesium levels. Since serum magnesium only drops when the body is severely low in magnesium, red blood cell (RBC) magnesium is more useful assessment.

Vitamin D3

Optimizing your level of vitamin D3 may be the single, most important thing you can do to support your health, hasten your recovery, and improve your athletic performance. Vitamin D3 controls or influences almost every physical process in the body; it is essential for peak athletic performance because it controls muscular strength and recovery, physical reaction time, balance, and coordination.  

Most people (even those who train regularly outdoors) are deficient (less than 50 ng/ml) in vitamin D3. In order for your body to fully recover from any illness or injury, it’s essential to optimize your vitamin D3. Less than optimal levels of this key, physiological factors can inhibit normal hormone production and, as a result, the body’s recovery response.  

Omega 3 Fatty Acids

Essential fatty acids (EFAs) have many functions in the body.  In fact, no cell, tissue, gland, or organ can function normally without them. Optimal EFA levels are critical in reducing inflammation, increasing endurance, shortening recovery, protecting the joints, improving mood and concentration, and promoting deeper sleep.

Our EFA status becomes stronger and healthier when we eat foods that are similar to those eaten by our primitive ancestors—abundant lean meats, antioxidant-rich fruits and vegetables, and fats with a high omega 3 to omega 6 EFA ratio. Due to the increased amount of unhealthy, processed fats in our food supply, most Americans don’t consume enough natural omega 3 fats (from fish, grass fed meat, seeds such as hemp and chia; and nuts such as macadamias and almonds) and too many processed omega 6 fats (from corn, soy, canola, and safflower oils).  This formula has led to performance-reducing imbalances in the ratio of omega 6 to omega 3 fats.  

Recent research suggests that we should strive for a low omega 6/omega 3 ratio (less than 3:1) and a high omega 3 index (greater than 10%) in order to reap the full benefits of essential fatty acid supplementation. While you may hear that taking flax, chia, or krill oil is a good solution, studies prove that the best way to achieve these critical ratios is with the regular use of a pure, high-quality fish oil. You can perform an Omega 3 Index Assessment at home with a fingerstick kit from Omegaquant or have your blood drawn at any Quest Diagnostics facility.

Nitric Oxide  

Nitric oxide (NO) is a critical, cellular, signaling molecule that declines with age. It not only helps your body restore its natural antioxidant capacity but is essential for regulating a variety of cellular metabolic processes including detoxification, blood flow, and energy production.  As women age, their blood vessels become less flexible and this can contribute to many health-related concerns including fatigue, cardiovascular disease, and poor recovery. You can easily assess your NO status at home with the use of a simple, salivary test strip.

Next week in my last post in this series, I’ll discuss assessments that will allow you to
dig deeper into a health issue.