What your blood test says about your age
What is special about BloodAge?
Our most favorite aging clock featured on Young.AI is probably BloodAge [1]. It takes in a PDF of a clinical blood test and returns your age. One may wonder, how could that be useful? I already know my age. However, BloodAge prediction is different from your regular, chronological age.
Chronological age is a measure of health and mortality risk in itself. Older adults have higher all-cause mortality, this is the very essence of aging. But chronological age alone lacks individuality. All people age at a different speed. A smoker or a regular drinker and a straight-edge person may technically be age peers, but aging is definitely progressing much faster in the former one.
[An excerpt from the 2017 US Actuarial life table [2]. Each cell shows the probability to die within one year at a certain age. The mortality risk in both males and females roughly doubles from 50 to 60 years of age]
It is possible to get a more accurate estimation of one’s pace of aging by learning more about their lifestyle or medical history. In fact, that is what we do with our other aging clocks, such as PsychoAge and LifeStyleAge [3]. But not all people know themselves very well, and even if they do, they may have hidden preconditions, not even their physician might’ve noticed.
This is one argument for the utility of BloodAge. It takes in an objective source of information that cannot be distorted by an “unreliable narrator”. The full power of BloodAge is unleashed when it meets a physician practicing within the 3P paradigm (personalized, predictive, preventive). The reports Young.AI generates for its users can bring not-yet-harmful trends to their attention and help prevent a major health event early.
Another argument is: BloodAge can track y̲o̲u̲r̲ longevity potential with no additional information. All people are different, and general scientific truths may not apply to everyone, or at least not to the same extent. Even modern randomized trials may suffer from sample bias. For example, all subjects come from the same population and are of the same ethnicity. Such design flaws are apparent to the conducting scientists and they are usually very careful about reporting the findings. The media, however, may be eager to amplify them.
Thus, not any intervention labeled as “geroprotective” is universally beneficial. Recent studies have critiqued the concept of “the best diet”. Personal dietary needs depend on genetics, gut microflora, meal frequency, sleep schedule, etc:
This high interpersonal variability suggests that … approaches that grade dietary ingredients as universally “good” or “bad” based on their average [glycemic response] in the population may have limited utility for an individual,
— David Zeevi et al. [4]
When a person is faced with a multitude of potentially geroprotective interventions, the two frequent questions are:
- How will my organism respond to this intervention?
- Are there any better alternatives?
The field of biogerontology is critically understudied, and quite frequently there are no clear answers, and sometimes there are contradictory results. BloodAge can provide the answers that apply personally to you. A user gets their BloodAge before the start of the intervention (it can be a novel supplement, a diet, or exercise regimen) and repeats the test in a month to see if it has worked. There is no more guessing if you should continue taking the supplement to notice its effects, or if it is actually harmful to you. BloodAge lets you and your physician navigate the world of longevity medicine. If your BloodAge has increased after starting a new diet, that is a sign that it might not be optimal for you. If your BloodAge goes down — you are on the right course! If no matter what you try, you can’t reduce your BloodAge, you might need to consult a longevity specialist. They will point out if your supplement regimen is off or if you have some underlying health issues that cancel the beneficial effects of what you have tried.
Top-10 blood biomarkers
We encourage our users to upload as many blood biomarkers as possible. This leads to more accurate BloodAge predictions and gives Young.AI’s recommendation engine more information to base its decisions on.
Currently, BloodAge can process blood tests with up to 46 biomarkers. But it also makes sense to provide the biomarkers that do not directly influence age prediction, such as hormones, vitamins, and microelements. This extra information will let your physician inspect the “blind spots” of BloodAge see the full picture.
Although all 46 biomarkers should be present for the most reliable BloodAge predictions, not all of them are equally important. For some blood parameters even slight perturbations can cause drastic shifts in the predicted age, while for others — as long as its value is within a reasonable range, BloodAge will not react.
We have ranked all BloodAge variables according to their impact on the pace of aging prediction. So, we present to you a list of top-10 most important blood biomarkers:
Red Cell Distribution Width (RDW)
Red blood cells (RBC) carry oxygen in the bloodstream. The “distribution” part of RDW is the distribution of their sizes, and the “width” is its variance
Normally, RBCs are roughly the same size and form, thus low RDW means that everything is fine. But if something is interfering with the normal RBC formation process, RDW will go up.
Alcohol consumption, iron deficiency, or vitamin B9/B12 deficiency are the most common causes of elevated RDW [6, 7].
Normal range: 11.8–14.2%
Blood Urea Nitrogen (BUN)
Fat, carbs, and protein are the “big three” macronutrients that can be used to build cellular structures or consumed to produce energy. When protein is consumed, nitrogen-containing urea is produced as a byproduct. Normally, BUN is excreted with urine during kidney filtration, and generally speaking, low BUN is a good sign.
High BUN can be caused by kidney conditions (stones, damage, infection), a high protein diet, or diuretics [8]. If your BUN suddenly goes up and you can’t think of a harmless reason for it, you need to make an appointment.
Normal range: 2·1 - 7·1 mM
Creatinine (CREA)
Creatinine is another marker of kidney health [9].
It is a byproduct of normal muscle metabolism. Thus, people with greater muscle mass will have higher blood creatinine levels. Consequently, it is not the best kidney health marker for muscular people [10].
Its precursor, creatine, is a popular fitness supplement, and taking it will increase your blood creatinine.
Normal range:
- Female: 53 - 97 uM;
- Male: 62 - 115 uM
Albumin (ALB)
There are many proteins within the non-cellular blood fraction, serum: immunoglobulins, clotting factors, hormones… But 60% of all serum protein is composed of a single protein — albumin [11]. It serves as a carrier of such small molecules, as fatty acids and microelements, and is produced in the liver. It is also an emergency protein storage that is tapped into during starvation [11].
Obesity, smoking, or taking prescription drugs can lower albumin. High albumin is most common in dehydration [12, 13].
Normal range: 34 - 48 g/L
Mean Corpuscular Volume (MCV)
“Corpuscules” in this case stand for RBC. As in the case with RDW, all RBCs should be roughly the same, normal size. Too big or too small RBCs mean problems with blood formation, which can be caused by alcohol, iron or vitamin deficiency, medication or some thyroid disorders [6,7, 14].
Normal range: 80 - 100 fL
Fasting Glucose (GLC)
Fasting blood glucose is a measure of how well your organism metabolizes sugar.
Insulin is a protein, whose function is to bring glucose from the bloodstream into the cells, where it can be consumed for energy or transformed into compounds more suitable for long-term storage. High blood glucose means that the organism cannot manage the carbs it consumes efficiently.
Consistently elevated fasting glucose is a sign of prediabetes, and consistent glucose >8mM is common among people with diabetes [15].
Blood glucose is also increased by obesity, smoking, and stress [16, 17, 18]
Normal range:
>60 years: 4·4 - 6·4 mM
≤60 years: 4·1 - 5·9 mM
Alkaline phosphatase (ALP)
ALP is an omnipresent enzyme, but the blood ALP originates mostly in the liver. Thus, it is used as an indicator of liver health. Liver damaged due to trauma, infection (hepatitis), gall stones, alcohol or medicine will leak ALP into the bloodstream. In more rare cases, ALP may leak from the bones, which is followed by abnormal phosphorus and calcium levels [19].
In zinc and magnesium deficiency, ALP is decreased. If you have consistently low ALP, you investigate if your diet is rich in microelements and consider taking a microelement blood test [20].
Normal range: 25 - 100 U/L
Red Blood Cell count (RBC)
RBC-associated metrics pop up for the third time in this list. This may be interpreted as an indication of (1) how important efficient gas transfer is within the context of aging and (2) how fragile RBC formation is to age-related stress causes.
Normal range:
- Female : 3·8 - 5·1 x10E12/L
- Male: 4·3 - 5·7 x10E12/L
Sodium (NA+) and Chloride (CL)
Sodium is a major electrolyte, and the regulation of urine formation and blood volume upkeep is tightly linked to its concentration. It also regulates muscle contraction and nerve signal transduction.
High sodium leads to water retention, increased blood volume, and consequently, higher stress on the vessels and the heart [21, 22]. It is generally recommended to reduce your sodium intake by eating less salty foods (table salt is 40% sodium in its weight and 60% chloride). Many processed foods and snacks have high salt content since salt enhances the flavor.
Note that low sodium also disturbs the electrolyte and blood volume balance and has adverse effects as well. If you have a heart condition, or your family runs a history of heart failure, sodium is the most important blood marker you need to control.
Chloride is an electrolyte as well, and together with sodium they can indicate kidney problems or consuming inadequate amounts of water. High blood concentration of these minerals can be a sign of dehydration, conversely, low concentration can mean drinking too much water [21].
Normal range:
Sodium: 136 - 146 mM;
Chloride: 98 - 106 mM.
Final notes
Remember, that these normal values are population-wide average ranges. Each person also has their own normal range, which can be established by taking regular blood tests.
Keep in mind, that the general assumption for all blood tests are that the patient did not drink alcohol or have heavy meals the previous day. If you are using prescription drugs, be aware of their effects on blood parameters.
References
[1] Population Specific Biomarkers of Human Aging: A Big Data Study Using South Korean, Canadian, and Eastern European Patient Populations; The Journals of Gerontology, 2018
[2] US Social Security Administration, Actuarial Life Table 2017
[3] PsychoAge and SubjAge: development of deep markers of psychological and subjective age using artificial intelligence; Aging US, 2020
[4] Personalized Nutrition by Prediction of Glycemic Responses; Cell, 2015
[5] Permutation importance: a corrected feature importance measure; Bioinformatics, 2015
[6] New insights into erythropoiesis: the roles of folate, vitamin B12, and iron; Annu Rev Nutr, 2004
[7] Claude Bennett J. Cecil Textbook of Medicine. 2000;159: 846.
[8] Pagana KD, Pagana TJ. Mosby’s Manual of Diagnostic and Laboratory Tests — E-Book. Elsevier Health Sciences; 2017: 453–456.
[9] Pagana KD, Pagana TJ. Mosby’s Manual of Diagnostic and Laboratory Tests — E-Book. Elsevier Health Sciences; 2017: 171–173.
[10] Influence of Muscle Mass and Physical Activity on Serum and Urinary Creatinine and Serum Cystatin C; CJASN, 2008
[11] Busher JT. Serum Albumin and Globulin. Clinical Methods: The History, Physical, and Laboratory Examinations 3rd edition. Butterworths; 1990
[12] Association between serum albumin and mortality from cardiovascular disease, cancer, and other causes; The Lancet, 1989
[13] Obesity and morbid obesity associated with higher odds of hypoalbuminemia in adults without liver disease or renal failure; Diabetes Metab Syndr Obes, 2017
[14] The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data; J Clin Endocrinol Metab, 2018
[15] Single, community-based blood glucose readings may be a viable alternative for community surveillance of HbA1c and poor glycaemic control in people with known diabetes in resource-poor settings; Glob Health Action, 2016
[16] Obesity, unfavourable lifestyle and genetic risk of type 2 diabetes: a case-cohort study; Diabetologia, 2020
[17] Stress-Induced Hyperglycemia; Crit Care Clin, 2001
[18] Effect of cigarette smoking on the blood glucose level in normals and diabetics; Med Interne, 1980
[19] Pagana KD, Pagana TJ. Mosby’s Manual of Diagnostic and Laboratory Tests — E-Book. Elsevier Health Sciences; 2017: 43–45.
[20] Low Alkaline Phosphatase (ALP) In Adult Population an Indicator of Zinc (Zn) and Magnesium (Mg) Deficiency; Current Research in Nutrition and Food Science Journal, 2017
[21] Pagana KD, Pagana TJ. Mosby’s Manual of Diagnostic and Laboratory Tests — E-Book. Elsevier Health Sciences; 2017: 417–420
[22] Sodium Intake and Heart Failure; MDPI Molecular Sciences, 2020
Header photo by National Cancer Institute on Unsplash
About Deep Longevity:
Originally incubated by Insilico Medicine, Deep Longevity was
acquired on 14 December 2020 by Regent Pacific Group Limited
(SEHK: 0575.HK), a specialist healthcare, wellness, and life sciences investment group.
