How low an HbA1c is too low?

[dougtokyo]

I was reading about HbA1c and diabetes at Forks over Knives (https://www.forksoverknives.com/health- ... -diabetes/) and they said to post questions here. They say what HbA1c levels are too high, but not what is too low.

This is a strange one for me. I've done really well these past 5 years on WFPB, losing 140 lb and currently maintaining at 144 lb. I was even interviewed by Chef AJ and Dr. McDougall asked me in email if I could be a star McDougaller. See https://lerner.net/december-2022-biannu ... way-to-go/ for more about me.

Anyway, my HbA1c started at a dangerously high 11.8 some years ago. Over time it came down to 5.1 and I've been off all sugar meds for over 3 years now.

Since my next blood test isn't until June (if then - the doctor at the hospital I periodically visit said I may not need more blood tests) my local clinic, which I also visit regularly, wanted to do a new blood test just to see how things are. I got the results today:

(normal ranges are in parentheses)

Total cholesterol: 139 (130-219)
Triglycerides: 73 (30-149)
HDL (good cholesterol): 42 (40-79)
LDL (bad cholesterol): 76 (70-139)
Uric acid: 5.9 (3.6-7.0)
Glucose (an hour after breakfast): 87 (70-109 after a long period of no eating)
HbA1c: 4.5 (4.6-6.2)

The last one was... whoa. Why is it down so much? Why is it out of the normal range? And what does it mean if your HbA1c is too low - which I've never had to wonder about my whole life!

I feel great. Lots of energy. Lots of walks. Doing great for 66 years old. But after some Internet searches of "low HbA1c" I was feeling a bit worried.

What's the WFPB thoughts on this?

Thanks.

[debknott]

You might want to send your question directly to Dr. McD. He could probably tell you if it's something to worry about or not. My guess would be that it's nothing to worry about, as it is only slightly low, but Dr. McD or your own doctor should be able to answer this for you.

Congratulations on your many healthy changes!

[dougtokyo]

I'll try that. I wonder if it might be due to eating a lot of cassia cinnamon lately. Thanks.

[dougtokyo]

I'm excited to report Dr. McDougall's response. He is always so responsive and helpful:

Please tell FOK I was happy to answer your question.
Congratulations on your success. You are a star mcdougaller.

Lab values are based on the population average. This population is sick from the food and as a result the “normals” are high.

A value of a HgB1c of 4.5% should be given an “extra great” rating.

On medication you might be able get this reading or with an insulin producing tumor.

With your history of excellent health and your other lab values the lower reading is easy to explain.

John McDougall, MD

[debknott]

Wow! What a wonderful response to your question! Keep up the good eating!

[Atheria]

DougTokyo,

First off, I like your screen name as I REALLY want to go to Japan! Secondly, I'm envious of your A1C number. The last time I was checked I was at 5.1 and bragged about that, but I'd love to be under 5. My mom has Alzheimer's and her mom died from it. Mom didn't properly control her blood sugar and Alzheimer's is referred to as diabetes of the brain/type 3 diabetes by some people. You are doing a good job of protecting your brain with a 4.5 number.

Keep up the great work!
Atheria