The conventional view of health is absence of disease or infirmity. Yet the processes happening at a molecular level that determine our propensity for disease remain almost wholly invisible to us, making "absence of disease" a poor yardstick of health. As the saying goes, you don't know what you don't know.
But what if you could? Optometrists and most physicians are comfortable addressing symptoms or consequences. If you come out of your comfort zone, you can discover opportunities for physiological recovery and disease prevention years or even decades before symptomatic involvement would occur. Predictive biomarkers yield clues to processes that govern health (Table 1). The eight discussed below address the 92% of lifetime health risk and resilience that encompass epigenetics.
In fact, optometrists already routinely use three (HbA1c, hsCRP and vitamin D status) of these. This guide reviews them plus five others, all of which together comprehensively address the immune system. Several of these and other tests can be accomplished at home by patients themselves under your guidance.
Here, The Ocular Wellness and Nutrition Society presents the work of Russell Jaffe, MD, PhD, a board-certified clinical pathologist. He served at the Clinical Center (1975-79) after completing his pathology residency at the National Institutes of Health, where he was a US Public Health Service Officer from 1973-79.
As this is a complex topic, we provide the high-level overview here; readers interested in more detail can learn more at: www.ocularnutritionsociety.org and www.healthstudiescollegium.org.
 HEMOGLOBIN A1c STATUS
Sugar and its derivatives attach to the hemoglobin (Hb) protein in red blood cells (RBCs) with a lifespan of three months. HbA1c levels are an effective way to observe blood sugar over that time frame. Normal HbA1c levels are considered 4% to 5.6%. If HbA1c increases by 1%, the risk of myocardial infarction triples.
Pre-diabetic patients present with an HbA1c level between 5.7% and 6.4%. Values greater than 6.5% are considered diabetic. According to the Diabetes Control and Complication Study, lowering HbA1c levels can reduce instances of retinopathy by 76%, neuropathy by 60% and nephropathy by 50%. Monitoring HbA 1c allows us to infer insulin resistance that accompanies the three major killers in the United States: cardiovascular disease, cancer and Alzheimer's.
The least risk/best outcome value for HbA 1c is <5%.
Another marker of sugar stuck onto protein is fructose-mine, whose half life is about a month. When red cell survival or marrow functions are uncertain, fructose-mine measurement is recommended. Fructosamine <150[micro]mol/L is the goal or best outcome value.
 HIGH SENSITIVITY C-REACTIVE PROTEIN
Chronic inflammation is the body's major manifestation of a 'repair deficit' and a core conceptual component in understanding why humans get chronic degenerative diseases. High sensitivity C-reactive protein (hsCRP) is a non-specific liver marker induced in proportion to systemic inflammation. Normal levels range between 1mg/L and 3mg/L. Higher levels correlate with greater risk of heart attack; 2.4mg/L constitutes a doubling of cardiovascular-related events compared with levels below 1mg/L. Concentrations of 10mg/L or higher are typical of a non-cardiovascular etiology, such as infection or underlying...