HBA1C Basics

(Jeff) #1

Sorry if I’m asking strange questions, but I’m trying to get started with Keto and I’m not sure I’m understanding HBA1C.

Quick Background: I started general “low carb” about a month ago and have had some stops and starts with Keto in the weeks since. I’ve been about half low carb and half SAD (standard american diet) as I’ve tried to get used to the Keto mindset and get settled into this new lifestyle. (I have a very stressful career situation, so I know that is not helping things. I only mention it here to provide background, not to try to deal with it right now) I’m pretty sure I have not yet been Keto during this, but I have gone several days at a time with extra low carb, and really felt different (better) when I did.
I’m 46, weigh 320-ish, been overweight all my life, and my dad is type 2 diabetic.

So, I wanted to get a starting HBA1C so I could see how the low-carb/keto lifestyle changes things.
I tried to get in to see my doctor for bloodwork and a basic checkup (I’m a couple years overdue), but the earliest I could get an appointment was late April (about 7 weeks away).

So I broke down and went to CVS for a home HBA1C test today.
The results were 6.1
I ate last night at 8pm and skipped breakfast today, and took the test at about 9am.
I’m fasting today for 23-24 hours (probably eating dinner tonight with the family) in the hopes of helping break the log jam on getting going with Keto.

What is a “good” HBA1C number for someone to be aiming for? Random google search says <5.6 is normal, 5.7-6.4 is risk of diabetes, and 6.5+ is diabetic (WebMD)
Does the Keto world see HBA1C numbers differently or agree with this?
Did it matter that I skipped breakfast before this test? (since it is a 2-3 month result, I would guess probably not)
How accurate are these home tests for HBA1C?

(A ham loving ham! - VA6KD) #2

I’m going to say not very for this question. I think I read +/-20% is typical. I too bought that kit in early January. The first test gave me 6.0 and the second a month later gave me 5.5. I had lab test two weeks before I bought the kit and it came back at 5.0. I can’t see how my A1C went from 5 to 6 in two weeks and I put it down to inaccuracy in the kit.

(Dameon Welch-Abernathy) #3

This seems fairly in-line with what I’ve seen discussed here.
Personally I’m aiming for a 5.0 (my last test in December was a 5.9).

I would also get yourself a blood glucose meter and test yourself periodically, which will give you a better idea of where you are on a day-to-day basis, versus the A1C test, which is more of a 3-month average.

(Jeff) #4

Keehan, do you think it would be worth it to do a second home test today? They came as a 2-pack and I still have one. I could use the average as my baseline starting number.

(Jeff) #5

Phoneboy, are you talking about a meter like type 2 diabetics use daily?
Do those give results in the same format as the 3-month test? Meaning they could give a 6-point something like my HBA1C test?
(Of course the daily one would vary quite a bit more up and down based on what I’ve eaten recently and how my body is handling it)

#6

You’ll be told on here they are not accurate, however there is never a study quoted just opinion. Before, I have a doctor lab for HbA1C, I run a home test to see. I have done this for 5 years or more and the home test is always right on! I’m not sure why people say they are not accurate.

(Sarah ) #7

You’re on the right track. The ideal number is what’s right for you… your body will eventually find its sweet spot, and most likely that’s somewhere around 5 or a bit more. You’re number is higher than it should be, and that level of upward creep is pretty typical for a person who has been on a carb heavy diet for a long time. This test isn’t a good marker for the over all success of the keto diet though. It’s a great way the get some feedback that you’re not doing it wrong, but if it drops .3 or.5 in the next 3 months is not that important. It’s much more important that you find a way of eating you can stick with, (meal timing, food choices),enjoy the energy and the “side effects” like more stable moods ,better skin (a great indicator of balanced health), easier relationship with meals. Focus on getting your kitchen prepped with a few core foods, get some electrolyte mix or look at recipes for keto aid.

Here’s a couple links, one about why hga1c is not a be all end all number, and one comparing units accross countries, since many people here use different measurement units.

http://bloodsugardiabetes.org/blood-sugar-a1c-chart

(A ham loving ham! - VA6KD) #8

There seems to be a wide error margin on these kits. If you look at the reviews online (CVS and Amazon, plus some of the other brands that all look like they use the same harware), they seem to be hit or miss with people saying either they were spot on or way off. Do you have any way to get a lab A1C test done?

Edit:. Here’s a study of 110 subjects testing the results of a home A1C kit. It shows of 177 samples, 165 of them were within an accuracy of +/-13.5%

(Consensus is Politics) #9

HBA1c is a tool used to measure your average blood glucose over the past three months. It’s not going to tell you if you are on an upward/downward trend. It doesn’t have the granularity, detail, resolution. But it can tell you if you are in trouble. My HBa1c was 11.8% in Aug 2017 (the Doc told me that, that value means I had an average blood glucose of over 300 for the last three months! A toxic condition. My BG for that day was 594! A value of 600 is considered deadly) . I was diagnosed with Type 2 Diabetes then. Long story short… I got my own BG meter, and one from the VA medical. I was testing regularly. As in several times a day, with both meters.

I eventually went Keto because the standard diabetic diet recommended by the ADA was doing nothing. Two days after starting Keto my BG was well under control. Four months later my HBa1c went from 11.8% down to 5.8%. With the only health care professional that even cared being a nurse who was in total awe of the numbers. I believe she is a Keto convert now after being exposed to the data.

You stated you are only doing Keto a few days at a time to ‘acclimate ‘ to it (my term). That’s not really going to help much. If you are still eating SAD, then your body will never get into Ketosis, and I seriously doubt you will ever see a difference, possibly even get worse as you begin eating more fat that is just going to get stored away as fat, never getting burned as fuel.

Try going 100% carb free for one month. Keep your eating window as narrow as possible. Pick a four to six hour time frame, say, 10 am to 4 pm. Eat/snack only during that time. Eat until you are no longer hungry. Don’t be afraid of eating too much. Just eat until you don’t feel the need to eat more. If you want to lose weight, the most important thing is keeping insulin levels as low as possible for as long as possible. I only eat one meal a day now. Around 10 am. And I have never felt so good. I’ve been lost a total of 50 pounds now. 40 pounds of that in the first 14 days. So do know, this does work.

(Robert Hollinger) #10

If it was the A1CNow test it used to be pretty accurate. That was before Bayer bought the tech and then shut it down and then apparently Walmart bought the tech (via ReliOn). I used the test before Bayer bought it and had a real test run the same day and it was generally within a tenth (different labs will have slightly different results too so that was far more than accurate enough for my needs at the time)

I tried it when Walmart was selling it and took two tests in a row and got two significantly different results. I don’t think WalMart is selling it any longer and I see that CardioChek now owns the brand. They are selling it as a diagnostic tool for Dr Offices in 10 and 20 packs. I think they are selling a home use version as well. Perhaps they have different levels of accuracy. My friend just bought the office kit to share with some others. He took the test twice and got 4.5 and 4.6. So it seems to be accurately consistent. But I don’t think his glucose control is quite that good since his fasting numbers are over 100. I’m going to try it tomorrow. My A1C was down to 7 2 weeks ago (real lab) down from 9.1 about 6 weeks ago. my fasting numbers have been a little better than his but I’m still over 100 as well. I would be surprised if my A1C is less than 6. The worst glycation would have occurred in December so it should be dropping pretty quickly but my liver is still keeping my average glucose above 100.

I’ll report back tomorrow with how well it seems to have worked.

But if we could only get an in-home Insulin test!

(Jeff) #11

I’m sorry I didnt express myself clear enough.
I’ve not been doing Keto just for a few days at a time… I’ve been trying to go keto all the time, but have fallen off the wagon so that the end result has been that in reality I’ve been very low carb (keto) maybe a third of the time, and just “low carb” about one third of the time and, and the other third I’ve been back to unhealthy eating.
I didnt want to fish for sympathy, but just report what I actually accomplished in case it was pertinent to my HBA1C questions.
Sorry for the confusion.

As for “try going 100% carb free for one month” that sounds hard for me to do, but I can aim for <20g carbs pretty easy if I set my mind to it. I was Paleo for 6 months a few years ago and lost about 50 pounds (probably was keto through much of that without realizing it) and so I have a pretty good idea of how I can eat very low carb.

100% carb free just sounds really extreme. I can totally agree with 100% no breads, grains, starchy veg (corn, potatos, etc), added sugar, etc… But to give up my precious Brussel sprouts, asparagus, broccoli, or salad (with vinegar & oil dressing) seems like too strict for me. I’m one of those strange kids that grew up eating a variety of veggies and actually like almost all of them. There are very few veggies I won’t eat. I love variety.
Besides, as I’ve heard some Keto people say, I need a way to get more real butter, olive oil, and coconut oil into my stomach, and certain veggies are a great way to do that without adding much in the way of carbs, aren’t they? (wink, wink)

Then there is this other part of me that hears you say “100% carb free for one month” and I think… I can probably do that. Besides, which is more “extreme” for my body: 100% carb free for one month or falling back to the SAD diet (standard american diet)?

When you say “100% carb free for one month” are you saying this (1) as a way for me to go all in and try it because after a month it will be a habit, or (2) is this a stricter first month and then I can add back in safe carbs (low carb veggies like I mentioned) after the first month?

(Jeff) #12

Thanks to everyone for your feedback about HBA1C home tests. The 2-pack I got was from CVS and was their store brand: “CVS Health”.

(Robert Hollinger) #13

I just looked. It’s the same exact tech so I’m guessing they licensed it out. But I doubt the at-home version is passed through the same quality requirements that theoretically the in-office version is. Or the tech has gone downhill drastically in the past 10 years. (entirely possible)

(Diane) #14

Jeff. You said you are trying to get in to see your doctor. You might be able to call the office, tell them you have an appt. and would like to have your lab results available to review with the doctor at that appt. Ask them If it’s possible to get a lab order from for the tests he/she would want to see. If it’s been several years since you’ve had blood work, you might ask if it’s possible to get a comprehensive metabolic panel (which tests liver function, kidney function, electrolytes, etc), a lipid panel, fasting insulin and HgA1c. Personally I would want to test for vitamin D levels as well and inflammatory markers such CRP (c reactive protein) and ferritin. I think it’s very likely the doctor would sign a lab order for you.

You could then take the order to an outpatient lab and get your blood work early. Be aware, The lab might not provide the results to you until you actually go in to review those results with the doctor. You could then start your Keto journey when you are ready and still have good basleline blood work for comparison to see how this way of eating is affecting your health. I would ask for a copy of the lab work for your records from the doctors office at the appt if you haven’t seen them before that.

When I started eating ketogenically, I was really hungry for the first week or so. I found that what worked well for me was to be really careful about monitoring my carb intake. I used (and still use) the Chronometer app for my phone (there are lots of other apps that different folks here on the forum have found useful in their journeys). I count net carbs and keep them faithfully under 20 per day.

I ate when I was hungry, which was a lot that first week. I tried to keep it to 3 meals without snacking, but if I needed to, I ate when I was hungry and added fat calories after getting in my protein (avocados, olives, pork rinds, egg yolks, cream cheese, etc). I think when I was switching from burning carbs to burning fat, my body screamed out for more food. I just provided fat calories for energy instead of the carbs. It seemed to stop screaming at me so loudly after the first week.

The one thing I didn’t do, which I wish I had known about, was supplement my electrolytes. That would have really helped out with the “Keto flu” symptoms.

I didnt worry about my eating window until I got into ketosis and my body started getting better at using fat for fuel (which can take up to 6 weeks according to the sources I’ve read). It seemed to take longer for me due to some health issues and my age.

Good luck!

(Jeff) #15

On the doctor stuff… is that a typo or is HgA1c the same as a HBA1C?

For the app you mentioned, you said “Chronometer” but I found 2 iphone apps named “cronometer” and “CRON-O-Meter” both by the same company. Is that what you meant?
It has settings for a Keto diet as well as being able to set nutrient targets like max carbs and protien.

(Diane) #16

I believe both HgA1c and HbA1c are abbreviations for hemoglobin A1c. I have seen the first in the clinics where I worked. But the HbA1c looks to be more common when I googled it just now.

Yes, the “Cronometer” or “Cron-O-Meter”app is the one I use. I paid for an upgraded version. About $2.99 I think? I’ve had to play around with it a bit to figure out how to put in my own macro goals and to use some of the features like weight graphs (I can also graph my blood glucose and ketone levels over time). If you get the app, and need help figuring out how to use it, go to the website. You can search there and get good help I couldn’t find on the app. Feel free to message me and I might also be able to save you some time or stress.

(Dameon Welch-Abernathy) #17

Yes, that’s exactly what I’m talking about.
No they give you different results because they measure different things.
A blood glucose meter tells you what your blood sugar is right now.
A1C gives you an idea of what your blood sugar has been over the last three months or so.
You can convert a blood glucose reading of mg/dL to an estimated A1C using the formula: (BG + 46.7) / 28.7

(You've tried everything else; why not try bacon?) #18

Stick with “HbA1C”—“Hg” is the chemical symbol for mercury, and while it might be useful to know your blood mercury level, you also need to know your HbA1C, lol!

(Robert Hollinger) #19

For what it’s worth…my friend’s A1C came in I thought rather low but his last test was a while ago and he was much more recently diagnosed with a much lower A1C than I last had so it’s entirely possible that even with somewhat elevated fasting numbers that this could be an accurate A1C for him. He took the test twice and had a one tenth difference.

My Labcorps A1C a week earlier was 7.1 but I’m getting very close to the elimination of all glycated bloodcells based on having been strict keto since early January and most of the damage having been done in November/December. I took the test twice and had a .3 difference both showing that my A1C continues to move in the right direction.

Again this was the A1CNow+ test that is labeled with “professional” (comes in 10 or 20 pack) so it may have more stringent manufacturing requirements than the home-use version that comes with 2 tests.

(CharleyD) #20

This right here. Once I read my doc in on what I was doing he was fine with me walking in whenever and demanding my own labs (within reason, not sure they’d let me order a pregnancy test :thinking: ) all without an appointment. At the front window I just have to mention I’m here for labs and I may need to wait for the phlebotomist to get free.

Give that a shot, but it wouldn’t hurt to call first.