In 2012, there were about 16 million adults who experienced a major depressive episode—basically, a period lasting at least two weeks of disinterest or displeasure, correlated with other symptoms such as not sleeping, not eating, lack of energy and concentration, and poor self-image)—within that year.

In other words? One in 10 Americans suffer from depression. Today is National Depression Screening Day—and you needn't even go anywhere or pay a cent to assess your risk.

So here's what you can do. Head to this site to find a location that's nearest to you for a free, anonymous screening. If—like me—there's nothing nearby, you can still partake in an online screening (that's also free and anonymous).

Worth it? Yes. According to the World Health Organization, depression is projected to become the second leading cause of disability worldwide by 2020—and, if you feel like you have any of the symptoms of depression (difficulty in concentrating or remembering; fatigue; exacerbated pessimism; excessive sleepiness; overeating or loss of appetite; headaches, cramps; aches; thoughts of suicide)—this quick initial assessment can be super helpful.

If you’re like most people, you need a little inspiration when it comes to weight loss. Many of us have the energy to talk about it. "I’m going to join the gym and lose 50 pounds;" "If I start running, I’ll lose those extra 20 pounds;" or "My sister just signed up for P90X and lost 20 pounds. I’m going to do it, too." Actually taking action is another story.

Many of us have a desire to lose weight, but without a specific plan we're likely to fail. SPARK is a tool that can help us turn our dreams of weight loss and better health into reality. If you are ready to stop talking and start doing, these tips can help lead you in the right direction.

Specific

"If you aim at nothing, you'll hit it every time." —Unknown author

When setting goals, it is critical that they are specific. Rather than saying, "I need to exercise more" say, "I will walk for 30 minutes every Monday, Wednesday, and Friday." The more specific your target is, the more likely you are to adhere to it. It is important to write down objectives and review them often. For example, at the beginning of every week write your workout in your planner just as you would any important business meeting. Scheduling the time and exercise will help you follow through.

Positive

"Man often becomes what he believes himself to be. If I keep on saying to myself that I cannot do a certain thing, it is possible that I may end by really becoming incapable of doing it. On the contrary, if I have the belief that I can do it, I shall surely acquire the capacity to do it even if I may not have it at the beginning." —Mahatma Gandhi

Take a moment to review your daily thoughts. If you’re like many people, the majority of your thinking is negative and self-defeating. "I look fat in these jeans;" or "I will never lose those extra 10 pounds;" or "I’m never eating bread again." The tendency is to be drawn to things weighing on our mind, so if our thoughts are negative, that is exactly what we will attract. When setting your goals, the same concept applies. Objectives should focus on the positive. Rather than declaring, "I will not eat any white bread this week," you could say, "I will substitute all white bread with whole-grain bread this week." Change "I won’t watch TV when I get home from work," with "After work I will spend 30 minutes outside working in the garden." Transforming your goal into a positive "I will" rather than an "I won’t" or "I can’t" will help keep you positive and focused.

Attainable

"So many of our dreams at first seem impossible, then they seem improbable, and then, when we summon the will, they soon become inevitable." —Christopher Reeve

Goals should be performance based rather than outcome based. A goal of being a size 6 again is focused on the end result. Although it is positive to focus on your goal, your efforts should be placed on how you will accomplish it. A better goal would be, "I will exercise 30 minutes every day" or "I will eat five small, healthy meals per day." These are both measures you can take that will help you achieve your ultimate outcome of a size 6.

Realized

"See things as you would have them be instead of as they are." —Robert Collier

We attract what we think about. So, if we continue to think about what we currently have, we will always have it. Set aside at least five minutes a day to focus on and visualize what it will be like when you achieve your goal. What do you look like? What are you doing? How do you feel? Put your thoughts into words and display them in a prominent location.

Food and Drug Administration (FDA) approved lorcaserin hydrochloride, a weight-loss pill, for sale in the United States. A pharmaceutical drug allegedly designed to curb appetite signals to brain receptors in the hypothalamus that promote satiety. Rejected in 2010 for causing tumors in tested animals, lorcaserin hydrochloride also claims side-effects ranging from memory lapse to depression.

The FDA has approved lorcaserin hydrochloride without condition for adults with a body mass index (BMI) above 30 or above 27 BMI contingent upon having high blood pressure, type II diabetes or high cholesterol. The manufacturer of lorcaserin hydrochloride convened 8,000 patients for its study, including a focus on heart valve function. The FDA released a less than convincing statement that lorcaserin hydrochloride "does not appear" to activate the serotonin 2B receptor responsible for heart tissue.

The side-effects and potential for heart valve damage spurred the FDA to set the daily dose level at 10 milligrams twice per day. Neither the manufacturer nor the FDA tested lorcaserin hydrochloride in patients with serious heart disease, yet they only caution use among heart disease patients. The FDA-approved label restricts the use of the drug to 12 weeks if five percent weight loss is not achieved, no time restriction is imposed if the five percent weight loss is achieved. Consistent with the modus operandi of the FDA, the general public will ultimately be the clinical trial, as the FDA is requiring the manufacturer to conduct six post-market studies on the risk for heart attack and stroke.

The FDA has approved the so called "weight-loss" drug for a period of 13 years. The manufacturer in Switzerland will be collaborating with a New Jersey company for distribution. The mainstream media has signed on to promote the drug with unsupported statements such as, "many doctors have urged health regulators to give the green light to new weight-loss treatments," and oxymoronic reassurances such as, "...but the agency [FDA] has set high standards for such medication after safety problems with previously popular weight-loss drugs."

Craving food beyond the point of feeling full is the body craving nutrients. Vitamins activate enzymes that allow for appropriate digestion. Without the correct nutrient intake, the body cannot utilize food efficiently and this results in both anxiety and obesity. Two side-effects of lorcaserin hydrochloride are memory lapse and depression. Ironically, these side-effects may cause the patient to forget to take your daily dosage, forget to consume a full complement of daily nutrients or fall into a depression-induced eating binge. Daily consumption of a full complement of nutrients combined with consistent exercise is the most natural and effective way to lose weight

If you thought we were going to tell you that you should have oatmeal or eggs for breakfast to drop pounds (how many times have you heard those before?) then we have some good news for you: Eating exotic dinner foods first thing in the a.m. is another great way to lose weight. Jason Sessions, the director of food and beverage at the Westin Princeville Ocean Resort Villas in Kauai, Hawaii, serves his guests dinner for breakfast, and all of the meals have weight loss-promoting properties. Check out his suggestions for fun, new ways to step up your breakfast game…and still slim down.

Hawaiian Poke
We know, we know: This is a mysterious word. It's pronounced "po-kay," and it's a popular Hawaiian dish that's basically just sashimi-grade Ahi Tuna—which is very low-cal—with a punch.

Sessions chops up the tuna into bite-sized chunks and then tops it with various sauces and fixins (all calorie-conscious, of course). Intrigued? The key is to get good fish to start with; just ask your local market for eight ounces of the best sashimi-grade Ahi they have. (Bonus: Since tuna is packed with protein, it'll keep you fuller for longer throughout the day.) And then, simply season it up! Session usually prepares his poke in one of the following two ways:

Hawaiian style: Top your Ahi cubes with one tablespoon of sesame oil, a handful of sesame seeds, a few flakes of dried seaweed, one small red or white onion (diced), and a sprinkle of chili flakes and sea salt.
Tahitian style: Mix your Ahi cubes with diced cucumbers and tomatoes, a small red or white onion (diced), two tablespoons of coconut milk, and a bit of lime juice to taste.

Kimchi
Most of the spas in Hawaii serve kimchi—spicy fermented Korean cabbage—for breakfast. Why? It's seriously good for you. Not only is it a superfood, but it's also low-cal. Plus, studies show that fermented foods can help speed up weight loss. Weirded out by the idea of having something pickled for breakfast? We hear you. But Sessions swears it pairs really well with more typical morning foods: "It has an acidic, vinegar-y flavor that people really enjoy with their eggs," he says. "I usually serve kimchi with scrambled eggs or tofu or with an omelet. It also goes really well in a breakfast burrito or wrap, and sometimes I'll even serve it with a veggie sushi roll for breakfast."  Not sure where to buy it? Your local Asian market will have it. Otherwise, most health food stores stock it, too.

Papaya Salad
Sessions often serves his guests sliced papaya over mixed greens with a homemade miso ginger dressing. Why is this a breakfast of champions? It's all about the ginger dressing: It's super low-cal, but it's also tangy—so it wakes you up and gets you ready to roll in the morning. And the fruits and veggies both contain lots of fiber, meaning you'll feel fuller for longer. You'll find authentic ginger dressing at your local health food store or Asian market. But if you want to DIY it, here's Sessions' recipe: Combine four ounces of white miso and six ounces of pickled ginger with six tablespoons sesame oil, eight tablespoons rice wine vinegar, four tablespoons of both soy sauce and sugar, six tablespoons of olive oil, a chopped green onion, and two ounces of toasted sesame seeds. Process everything in a blender until smooth, about 30 seconds. This makes more than one serving, so Sessions says you can use it for other things, too, like as a marinade for chicken or steak.

As a sports nutritionist, I recommend many of the athletes and clients I advise to undergo basic blood testing for vitamins, hormones, nutrients, and metabolic factors that directly affect health and performance. I personally test my blood four times each year.

After all, if you don’t know what’s going on inside your body, then how do you know you’re not one of those people who are healthy on the outside, but unhealthy on the inside? And if you struggle with anything like brain fog, constipation, bloating, low libido, poor sleep, or slow workout recovery, then you probably fall into the category of people who need to test their body.

As a matter of fact, even if you’re exercising hard and eating healthy, it turns out that what’s actually going on inside your body can be quite disturbing, and include:

    Low testosterone and high cortisol, manifesting in overtraining symptoms, low libido, lack of motivation, and loss of competitive drive.
    Low luteinizing hormone, high estrogens, and low progesterone, manifesting in brain fog, appetite cravings, and a seeming inability to shed fat despite lots of training.
    High thyroid-stimulating hormone and low thyroid hormones, resulting in a constant feeling of being cold, sluggish metabolism, and impaired digestive function, gas, and bloating.
    Low magnesium and electrolyte levels, which can cause trouble getting to sleep at night, waking up multiple times during the night, or being tired during the day.
    High inflammation markers, resulting in sore joints, nagging injuries that won’t go away, missing workouts from sickness or having sniffles all the time, and occasional ghost symptoms, like random headaches, heart flutters, or muscle tingling and numbness.
 
The Wide World of Testing

It can be confusing to navigate through the world of testing. There are certainly quick and convenient testing services such as WellnessFX and DirectLabs, which have bundled testing packages and allow you to purchase a test online, print a piece of paper called a requisition form, then bring it to a lab near your house for a quick and easy blood draw. But many people have physicians who can run these tests (allowing for insurance coverage), so I’m still often asked what the best parameters to test are if you want to get the most bang for your buck and find out exactly what’s going on inside your body.

So which blood values should you test if you’re concerned about issues like this or want a full, informed glance about what’s going on inside your body and what’s in your blood?

Without further ado, here are the top ten ways to test your body:

1. HDL:Triglyceride Ratio

While there are a host of things you can test on a cholesterol panel, such as LDL, total cholesterol, HDL, VLDL, etc., one of the most important parameters to pay attention to is your ratio of HDL to triglycerides. In people who are consuming low fiber diets high in vegetable oils and processed ingredients (a stereotypical “gym junkie” diet), I tend to see sky-high triglyceride and low HDL.

Your goal should be to get HDL higher than triglycerides, and preferably a 1:1 ratio or better of HDL:triglycerides.

 2. HS-CRP

C-reactive protein is a marker of full-body inflammation. Inadequate recovery or overtraining, high intake of inflammatory foods like sugar and commercial meat or dairy, and high stress levels can all elevate HS-CRP.

I recommend that for athletes looking for ideal levels of anti-inflammation, HS-CRP be consistently below 0.5.

3. Free Testosterone

For both men and women, testosterone is an anabolic, growth-promoting hormone associated with everything from fat loss to muscle gain to libido to heart health to anti-aging. But often, even if total testosterone is elevated, free testosterone is low. This is usually because total testosterone is bound to sex hormone binding globulin (SHBG). This typically happens due to excessive stress or inadequate calorie intake. A good way to do detective work on whether this is occurring is a free testosterone measurement.

Use this chart to look at the age group references for free testosterone and shoot for the top percentage for your age group.

4. TSH

Thyroid-stimulating hormone is made by a small gland in your brain called the pituitary and triggers your thyroid gland in your neck to produce thyroid hormones (triiodothyronine (T3) and thyroxine (T4)), which are crucial for your body’s use of energy.

In athletes and active individuals, high TSH is usually due to three factors:

    High cortisol levels causing cell thyroid receptors to be insensitive.
    Small intestinal bacterial overgrowth from gut dysbiosis, usually due to excessive carbohydrate intake, psychological stress, or both.
    Excessive caloric or carbohydrate restriction.

When you test TSH, look for ideal values to be between 0.5-2.0.

5. IGF-1

You’re probably familiar with growth hormone (GH) as a potent anti-aging and anabolic, muscle-building hormone. IGF-1, or insulin-like growth factor-1, is stimulated by GH and is an easier way to measure GH activity than to measure GH directly, which is a more difficult and inaccurate lab test. Both these hormones are the main hormones responsible for cellular and muscle growth, and both support anabolic pathways that lead to enhanced repair and recovery, so if IGF-1 is suppressed, then recovery is compromised.

Low IGF-1, specifically anything below about 115 ng/mL, is usually a result of lifestyle stress, exercise stress, and calorie restriction or nutrient depletion.

ben greenfield, blood tests, blood tests for athletes, athletes and blood tests

6. Vitamin D

25-hydroxy vitamin D is a blood measurement that allows you to see if your levels of this potent steroid and hormone precursor are adequate. Most athletes and exercisers tend to be deficient in this anabolic, fat-soluble vitamin, and often, low vitamin D correlates to low testosterone and high cortisol.

I generally recommend looking for levels between 40 and 80 ng/mL - and if you test low, don’t necessarily go out and mega-dose. Instead, get natural sources of fat-soluble vitamin D, such as wild caught fish, whole eggs, and liver.

7. Glucose

Just because you fall into the acceptable reference range for fasting glucose doesn’t mean you’re safe. For example, a doctor may look at a fasting glucose of 95 mg/dL and say you have no risk. But that amount of glucose in the bloodstream can cause over secretion of insulin that adversely impacts your cells, your recovery, and your waistline.

Fasting glucose levels should ideally be below 85 mg/dL in active individuals. If they’re not, you’re probably too stressed out (which mobilizes the liver’s storage carbohydrate) or you’re eating too much sugar.

8. Adrenal Stress Index (ASI)

An ASI looks at four different saliva samples at different points throughout the day, and helps to reveal the health of your adrenal glands. A basic ASI will measure two parameters:

Cortisol Levels: You’ll measure four different cortisol levels throughout the day to determine if you have a proper circadian pattern. Normally your cortisol levels should be at the highest levels in the morning and then decrease throughout the day. This pattern will help to give you the energy you need throughout the day, while the lower cortisol levels at night will allow you to rest and fall asleep.

If you’re overtrained, you usually have low cortisol levels in the morning, and they also tend to be lower than normal throughout the rest of the day. But as you’ve learned, it is common for the cortisol levels to be high in the initial stages of overreaching, as this is the body’s response to chronic stress. But over a period of time, the adrenal glands will weaken, which will eventually result in depressed morning cortisol levels.

DHEA: This is manufactured by your adrenal glands, and plays an important role in immunity and in the stress response. If you’re dealing with chronic stress on a regular basis, the chances are these hormone levels will also be low.

ben greenfield, blood tests, blood tests for athletes, athletes and blood tests

9. Heart Rate Variability (HRV)

HRV is an important marker of your nervous system health and recovery status. There are a variety of apps that measure HRV, and I personally use one called the SweetBeat.

HRV works this way: your parasympathetic nervous system (“rest-and-digest”) influences your heart rate via the release of a compound called acetylcholine by your vagus nerve, which can inhibit activation of your heart’s electrical activity and decrease heart rate variability. In contrast, your sympathetic nervous system (“fight-and-flight”) influences heart rate by release of epinephrine and norepinephrine, and generally increases electrical activity in the heart and increases heart rate variability. If you’re well rested, haven’t been training excessively, and aren’t in a state of overreaching, your parasympathetic nervous system interacts cooperatively with your sympathetic nervous system to produce responses in your heart rate variability to respiration, temperature, blood pressure, stress, etc.

As a result, you tend to have really nice, consistent and high HRV values, which are typically measured on a 0-100 scale. The higher the HRV, the better your score. But if you’re not well rested (overreached or under recovered), the normally healthy beat-to-beat variation in your heart rhythm begins to diminish.

While normal variability would indicate sympathetic and parasympathetic nervous system balance, and a proper regulation of your heartbeat by your nervous system, it can certainly be a serious issue if you see abnormal variability - such as consistently low HRV values (e.g. below 60) or HRV values that tend to jump around a lot from day-to-day (70 one day, 90 another day, 60 the next day, etc.).

10. Oxygen Saturation

Oxygen saturation (SPO2) is a measurement of how much oxygen your blood is carrying as a percentage of the maximum it could carry. Normal healthy oxygen saturation values are between 96% and 99% at sea level. Oxygen saturation below 95% may indicate lack of recovery, although it can also occasionally indicate anemia, especially when accompanied by chronic daily weakness, fatigue, and shortness of breath during exercise.

I generally look for values to consistently be above 96% in the athletes I work with.

ben greenfield, blood tests, blood tests for athletes, athletes and blood tests

How to Order Tests

Using online testing services, a full panel that includes the first seven tests above (along with a range of other tests such as red blood cells, white blood cells, kidney and liver markers, etc.) will typically cost $400-800, but in many cases, if you submit your receipt to your health insurance, they will cover part of the cost. You can also, of course, approach your physician to run these tests for you. The ASI, HRV, and SPO2 testing would be something extra, but these three are also important markers to track.

If you’re looking for a health expert to walk you through the entire testing process, but don’t know where to start, then I recommend finding a functional medicine or naturopathic practitioner in your area. Look for a physician who has worked with athletes or physically active populations and is willing to pay attention to parameters that affect not just health or risk of dying, but also performance and optimizing living.

Good website resources for this to start your search for a physician include:

    Health Profs
    Functional Medicine
    Naturopathic
    Primal Docs
    Paleo Physicians Network

Remember, even if you look great on the outside, it doesn’t mean you’re healthy on the inside. But you’re now equipped with everything you need to know to test your body in the best way possible, and truly find out what’s going on inside your body.