Recently, I was contacted by a 60 year old woman who wanted me to go over her blood work. Her fasting blood sugar was nice and low at 75. That's actually lower than mine, so I was a little envious. However, at the same time, she had marginally elevated HA1C.
HA1C measures the percentage of hemologbin that shows glycation damage. Glacation is a reaction between sugar moleculres and proteins in which the proteins get damaged. An example would be the proteins in the lens of the eye, which in their healthy state are completely translucent, but when they undergo glycation, they become opaque. Think of it like the change from raw egg white to cooked egg white, a process which is called "denaturing." Obviously, you can't see through cooked egg white, and it's the same for the ocular lens.
This woman's HA1C was 5.9% where normal is considered 5.7% or less. And, the fact is that some labs designate 5.9 as the top of the normal range, so really it was marginal. Nevertheless, it concerned her a lot, which is why she contacted me. I will point out that this woman is not the least bit overweight- if anything she is on the slim side. And she's feeling fine- there are no symptomatic issues.
The reason why HA1C is becoming recognized as a valuable tool is because it reflects the status of long-term glucose control. A simple glucose test only tells you what the blood sugar was at a single moment in time. But, blood glucose can fluctuate wildly. So, by looking at HA1C, you get an idea of how well glucose is being controlled over a period of several months.
It is probably true that HA1C is at least as predictive of future problems as any of the cholesterol tests and probably more predictive. And if I had to choose between being stuck with a high cholesterol or a high HA1C, I think I'd rather be stuck with high cholesterol. It would worry me more to have an elevated HA1C.
Now, what can you do about it? Well obviously, all of the factors that go into diabetes prevention apply, which means: eating a whole natural foods diet and emphasizing plant foods over animal foods, exercising regularly including aerobic and resistance exercise, maintaining a healthy lean to fat ratio (meaning retaining quite a lot of bodily muscle and not much bodily fat), and that's about it for the frontline defense. However, if you want to do more, you can consider taking anti-glycation supplements. Two of the best are Carnosine and Benfotiamine. Carnosine is a dipeptide, which means two amino acids holding hands, in this case alanine and histidine. It sounds simple, but Carnosine is as powerful an antiglycation agent as they come. Even the FDA realizes it because they have made Carnosine eyedrops a prescription treatment for cataracts. And Benfotiamine is the fat-soluble form of Vitamin B1 which has been used for decades in Europe to treat and prevent diabetes. It's commonly prescribed by doctors over there, and it's as safe to take as regular thiamine.
Those are the two anti-glycation supplements that I take. Another good one is P5P, which is an advanced form of Vitamin B6. I don't take it separately, but there is some P5P in the Extend Core multi that I take every day.
I am going to include the HA1C test in my annual blood work next April, and frankly, it will be for the first time. I never thought about doing it before because my blood sugar was always nice and low, so I figured, why bother? But now that I know that it's possible to have enviably low blood sugar while still having marginally high HA1C, I will start tracking it.