HbA1c Test and What HbA1c Normal Range Means

Today I want to talk about hemoglobin A1c (HbA1c) the levels the charts how to read

them and why A1c may be the single most important marker on a blood test and yet

it's often not even measured I going to explain everything that you need to know

Hey I am doctor Ekberg with Wellness For Life and if you like to truly master health

by understanding how the body really works make sure that you subscribe and

hit that notification bell so that you don't miss anything. A lot of people have

heard about A1c and glucose and insulin resistance and diabetes and they know

it's a big deal so we're gonna explain all the different pieces you need to

understand to make sense of all of that so first of all why is A1c measured?

well blood sugar is important but blood sugar can fluctuate tremendously

especially with a diet of refined foods so if you measure something at a certain

time then you could get a very different reading depending on the time you pick

so measuring glucose is difficult because it changes by the hour or even

by the minute so what they found was that the red blood cells these are red

blood cells they're floating around in the bloodstream and if there's a lot of

sugar in the bloodstream meaning high blood glucose some of that sugar is

gonna get stuck to the red blood cells to the hemoglobin and if there's more

sugar in the bloodstream there's going to be more sugar stuck to the hemoglobin

so they can measure the percentage of hemoglobin with glucose stuck to it and

they come up with a measurement hemoglobin A1c (HbA1c). So how did they do this

simply they took 500 people they did a long study they measured the glucose and

the A1c at varying times they plotted all of this and they came up with a

remarkably straight line so they knew that there was a very strong correlation

a very tight relationship between glucose and a1c then they came up with a

formula so now we can measure one marker a1c and get an average

of what the average glucose is because a red blood cell lives about three to four

months and during its lifetime it gets more and more sugar more and more

glucose stuck to it so depending on how much glucose is stuck we can measure and

figure out pretty much exactly what the average glucose was so now we have a

much much better measurement because even if it goes up and down a lot we can

still figure out what it was on average and that's much more important to know

than knowing what it was over here or over here so now we can create a chart

and we can figure out we know that an average glucose of 91 is equivalent to

an a1c of 4.8 average glucose of a hundred is equivalent to a 5.1 and so on

and they have defined normal as being anything up to a 5.7 between 5.7 and 6.4

is pre-diabetes that means that you don't have diabetes yet but you're

probably going to get it and above six point four or six point five six point

five and up is called diabetes they've defined that as diabetes but here's the

thing to understand that even though they have imposed these sharp

delineations they've put these these limits and say here it is this thing and

here it's something else it's all gradual okay here it does very little

damage and here it does a tremendous amount of damage because we know

diabetes it's just a label at one it's got over a certain point but diabetes is

associated with blindness with amputations and with kidney failure it's

the leading cause of all those things it's devastating in in today's society

but if we understand that the higher the number the more of these complications

we have then we also understand that a 6.4 is not as good as a 5.1 there's a

huge difference so we don't want to just look at this number and say oh good I'm

normal if we're after optimum health we want to understand this and try to bring

it in to the optimal range which in my experience and opinion and belief is

somewhere between four point eight and five point one so then people say well I

had my on my last blood test they measured my glucose and he came back at

a 90 so does that mean I have an a1c of four point eight no because when they

measured the glucose that means that was your fasting glucose level they caught

it at a certain time and we don't know where on that scale it was but if you

have an average glucose of a hundred that means a lot of times it's going to

need to be lower than that and sometimes it's going to be higher than that so for

example if you wake up in the morning and you have a fasting level of 80 and

then you eat something like something healthy like an omelet or some avocado

then it's probably going to gum up a little bit but not tremendously it's

probably going to stay in the 120 range and then as your body digests this over

several hours it's gonna gradually come back down again

your average level there might have been a hundred even though you're fasting

level was an eighty so that's the thing with the a1c it measures the average so

in a good day it will look like this for people who aren't quite so healthy but

still considered normal they might look something like this so

they wake up and they're starving they have hypoglycemia they're lightheaded no

energy they need to get something in them before they start functioning and

so they have some cereal and a doughnut and low-fat milk and now it jumps up to

a hundred and eighty and then it comes crashing down because of all the insulin

required to get this blood sugar out and it comes up and down up and down

throughout the day and yet their average is a hundred and twenty which by the

official guidelines is still normal it is not even pre-diabetic but this is not

healthy because this is toxic to the brain and

this level is toxic to the brain so here's sort of how it works this is not

an absolute but just like a scenario to give you an idea normal would be average

of a hundred and within a very tight range then we start eating some

processed foods and the blood sugar goes crazy but when it comes crashing down

the body still has some reserves we release some cortisol to bring up the

blood sugar the liver is working so it can break down some glycogen and get the

blood sugar up so we never totally crash but if we keep doing this now we develop

even larger swings and at the bottom here we get something called reactive

hypoglycemia because now the organs are little too tired that are a little worn

out to keep up with this abuse so now we get even bigger swings but we're still

considered normal maybe pre-diabetic maybe we're getting

into this range and then eventually the system just can't keep up at all it

can't get the sugar out of there quickly so now we have type 2 diabetes

maybe insulin dependent or non insulin-dependent but the blood sugar is

so high on average so consistently high that the pancreas can't create enough

insulin to push this out into the cells so now even though there's some swings

we have a steady high level and we're in diabetes so again it doesn't happen like

this every time but it's just a scenario of how this thing's can can happen over

time so what we want to understand is that even if the average isn't too

terribly bad we're still creating damage we're still not producing energy at a

steady level we're not functioning at our optimum and we're still developing

inflammation with all this insulin so there's lots and lots of different

different drawbacks to this scenario over this even though we're still

considered in the normal range and the other thing to understand about a 1c is

that because these blood cells live about 3 to 4 months these values

don't change very quickly so if someone says how do I bring down my a1c as fast

as possible well you start eating real food you eat you avoid the sugar and the

starches but it's still gonna take a while because let's say you start off

with a blood sugar of 180 and if you kept it there for a while

then your a1c would be about eight so you realize hey I'm killing myself this

is not a good thing let me change so you start eating real food and after a month

your average blood sugar as they measured with frequent pinpricks is

about a hundred and fifty and then in month three it's a hundred and twenty

five and in month four it's a hundred so then you go and you figure oh look I'm

gonna go get checked and my a1c should be about five no it's not going to be

because you still have some of the blood cells from previous months that were

still swimming around while your blood sugar was really high so even if you

follow this scenario and you're getting very healthy very quickly you're a 1 C

is going to be maybe 6.5 so the moral of the story is yes you definitely want to

do this but the a1c blood test may not reflect the true value because it's

lagging behind the if you get a 6.5 after four months you're actually doing

a whole lot better than this 6.5 is indicating so be patient with it and

realize that this is something you definitely want to keep track of but

it's not something that's going to change very quickly you want to have at

least the six or a nine month horizon on on getting this leveled out so we don't

do a whole lot of blood work in our office but I think there's a few markers

that are worth keeping track of and maybe at least get a baseline so that

you know where you're starting so you know what's been been going on and a1c

is one of those markers that we highly recommend and then we suggest for people

to get so while I was searching for a few questions on

Google I donned on me how many misconceptions there are out there so

one of the questions was what's a good a one see if you have type 2 diabetes

there is no answer to that because it is never good with diabetes but the problem

is people have been labeled they have been said oh look you have an a1c of 7

or 8 you are diabetic here's your medication instead of understanding that

this is physiology this is an adaptation your body has adapted to a long term

insult and if you stop the insult your body can reverse it so there is no good

a one-seed level for diabetes the only good way is to reverse the diabetes by

giving your body some real food and some good exercise and a healthy environment

and other people are asking how do I bring down my a1c quickly and again we

sort of talked about this that it isn't gonna go quick because there's gonna be

a lag but regardless you're gonna have to do the right things to get your body

healthy that's the only way that you can develop health and sustain health we

want to get rid of that idea of a quick fix ok you have to address the

underlying conditions you have to handle the cause of the problem and I can't

tell you how often I have people come into the office and they say oh you know

I have diabetes but my doctor says it's being controlled all right what that

means is that they are managing to keep it at an eight or a nine instead of a 14

so they're not going to develop as quickly as terrible complications as if

they didn't do anything but that's not a solution that's not

keeping it in control we have to understand that the body can heal if we

do the right things and the right things is to not listen to government

guidelines because they believe that grains and sugar and processed foods are

necessary in modern okay if you want to reverse this then

you get off sugar you get off of all the white flour but also you get off of all

the grain and all the processed foods you base your food on vegetables you

fill in with some protein and then you eat healthy fats until you're full

that's how you reverse this stuff because if you stop putting things in

the body that will cause blood sugar spikes then you will start reversing

this situation and what we've been talking about is a big problem because

there is probably less than 10% of the population that are in a good level

somewhere between 4.8 and 5.1 we have 50% or so at a level above 5.7 but again

in my mind I think 5.5 to 5.7 is like pre pre-diabetes it's not a place you

want to be if you're looking for optimal health just because something becomes

normal in the sense that most people have it that doesn't make it a good idea

or healthy just because you don't have symptoms yet doesn't make it healthy so

please share this information with as many people as you can because the more

we can get the truth out about how the body works and the optimum lifestyle the

better we can help people have quality of life if you have any questions let me

know I'll be more than happy to answer questions or make videos on additional

topics and if you have some experiences if you've been measuring your a1c s and

you have some feedback for me please share that as well I'd love to hear from

you thanks so much for watching