High-Frequency Blood Testing — What? Why? How?

For most of us, cholesterol and glucose testing happens once a year during an annual check-up.

Diabetic patients test several times a day with home blood testing kits — this is needed to manage that condition. The latest in continuous glucose monitors track at a much higher frequency, massively upgrading their quality of life and offer an unprecedented opportunity for everyday people to understand their physiology.

Although not as advanced as glucose testing, cholesterol testing is getting there.

In January at the Dublin Quantified Self meetup, the theme was high-frequency blood testing for cholesterol and glucose. On cholesterol, Azure Grant from Quantified Self labs in Berkley spoke, and on glucose, Donal O’Gorman from DCU, an expert in glucose tolerance in humans, speaking on cholesterol and glucose.

We got to find out — what’s the benefits of taking high-frequency tests for cholesterol and glucose?

Cholesterol Testing

Over the last six months, Quantified Labs have been running an experiment called ‘Blood Testers’ to explore what individuals could learn through up to hourly measurement of blood lipids (i.e., total cholesterol, HDL-cholesterol and triglycerides). The experiment involved 25 participants from the Quantified Self community over nine countries and three continents.

It turns out that our cholesterol levels change significantly within-a-day, and even from morning to morning, at the same time, in the fasted state. How is not yet fully understood — but this experiment is doing the initial mapping of lipid dynamics in the real world. This experiment is novel in two ways. First, to our knowledge it is the highest temporal resolution real-world observation of blood lipids ever conducted in humans. First Second, it is an extreme form of Participant-Led Research: participants own and control access and use of their own data, and can share expertise in research methods, physiology, tech and data analysis.

So what was found was that there are indeed cycles across the day, that respond to major events in our day — what time we eat, what time we wake or sleep at.

Cholesterol cycles illustrated over the day

So was that found in the data? Absolutely. Below shows Azure’s levels during the day — cycles in levels corresponding to waking, eating and other natural cycles during the day.

In addition to mapping fluctuations in lipids within and across days, what else did we learn?

• Vegan diets decrease cholesterol — over two weeks of moving over to a vegan diet, levels throughout the day remained considerably lower.
• Marathon training: one participant’s cholesterol and triglyceride levels gradually decreased during training.
• Variability from morning-to-morning in the fasted state was huge!

The third finding is likely most important. Is a single sample, tested once a year relevant? Keep in mind that these ‘once-a-year’ measurements play into a physician’s decision to prescribe cholesterol-lowering drugs.

This self-experimentation-in-a-group also brought up many new and interesting ethical concerns surrounding participatory research. Though Citizen Science has been growing in popularity for nearly a decade, research that explicitly directed, organized, and disseminated by participants has little precedent in the 21st century. In fact, it has spurred on a whole new field of ethics and legal regulation surrounding Participant-Led-Research (See Vayena and Tasioulas 2015).

For a deeper dive, Azure put up great explainer videos on cholesterol and biological rhythms in our bodies.

Glucose Testing

Diabetes and poor glucose control worldwide is a big problem.

Speaking next, Donal O’Gorman about glucose in the body and how to measure. An expert in the field, Donal leads the 3U Diabetes Partnership, as well as interim director for National Institute for Cellular biology (NICB).

Poor glucose control in the body doesn’t just lead to diabetes — the latest science is finding that it can cause complications in many other diseases such as obesity, heart disease, cancer or even Alzheimer’s.

Donal spoke about the history of diabetes — about type-1 diabetes, injecting insulin, glucose monitors and the latest continuous glucose monitoring.

For the near future, new technology is currently being developed to — from Apples iWatch having an integrated continuous glucose monitor through to insulin patches, releasing insulin when needed.

One key takeaway to reduce glucose levels — exercising throughout the day can have a massive benefit to glucose levels in the blood that last for the rest of the day, and even into the night.

Conclusions

High-frequency testing of blood brings much more information on health. With high-frequency data, there is potentially new science yet to be discovered about cholesterol testing and how we treat high-cholesterol readings.

High frequency data also show how complicated biomarkers are, interacting with the body in many ways that are still not fully known over the day.

Technology is advancing rapidly. With better technology will come better answers.

Links

• Slide decks from the night on cholesterol testing and glucose monitoring. The video from the cholesterol talk is here.
• Quantified Self HQ, and blog on Medium, and the Cardio Vascular Symposium being held in San Diego April 2018.
• Initial Quantified Self blog post on why to do high-frequency testing of cholesterol, video explainer on cholesterol and biological rhythms.
• Donal is head of 3u Partnership on Diabetes. Donal also spoke at a previous Quantified Self meetup in Dublin.
• Quantified Self Dublin meetup group and blog.