I Analyzed the World's Strongest Man's Bloodwork: Healthy or Bad?

Mitchell Hooper is the strongest man alive, two-time world's strongest man and four consecutive Arnold Strongman classic titles. He recently published his full blood work, and I wanted to know, can you actually be healthy while being that strong, especially on performance enhancing drugs? Now, I'm not a doctor, but I've researched various health biomarkers for nearly a decade, and I'm also ranked number one at the Longevity World Cup that calculates phenotypic age from commonly measured blood markers. Also, if you want to discover your own health percentile to know what level of health you're at, with various different types of biomarkers like your fitness markers, body composition, and blood work, what are your bottlenecks and biggest weaknesses, then take the health assessment in our top 1% health community, link in the description. I am the world's strongest man, I take performance enhancements, and I'm going to die. Today, I'm going to give you guys a look under the hood of the world's strongest man's blood work. There are a couple of things that work against you when you are a professional strength athlete, and in my case, I am obese, my total exercise volume is lower than it should be to be healthy, and I take performance enhancing drugs. This is something that people might not associate immediately because he doesn't look clinically obese. He is around 145 or 150 kilos, which is quite a lot. He's also quite tall, 191-193 centimeters. His BMI is like 39, which puts him definitely in the obese category. This is what I call muscular obesity, like a lot of bodybuilders, strongman athletes, powerlifters, they all fall into. Yes, they're not clinically obese that they have excess body fat, but because they have a lot of muscle as well, on top of that, muscularly obese, in that sense that he carries just too much muscle mass and also too much body fat. I want to shed some light on the conversation of peak performance and peak health are not the same things. In any sport, in any way, if you are chasing an individual quality, it is at the expense of many other things. I definitely agree with that. The professional sports makes you sacrifice a lot of your health, especially if you want to be at the elite level. He's at the elite of the elite. He's the best of the elite, one of the strongest men in the world. He obviously has to sacrifice his health. Without further ado, let's talk about what I took to get myself into the position where my blood work and organs breathe abnormally. There are three major things that I take as testosterone, anhydrol, and halo. This is just to lead up to competition in terms of anhydrol and halo. These are pills. What I'm predicting based on this blood work, I haven't seen his blood work yet, but I'm predicting that because he exercises quite a lot, he's going to have good metabolic health markers in terms of good glucose levels, good triglycerides, although those triglycerides will probably not be in the most optimal range. He's probably going to have slightly worse kidney function because of excess muscle mass and just body fat plus the PEDs. He's probably also going to have elevated liver enzymes, elevated lipids like cholesterol, etc. That's what I'm predicting based on what usually happens with people who take performance-enhancing drugs and people who just have insane amounts of muscle and body fat. The general measurements of how well the kidney is functioning is your EGFR or your glomerular filtration rates. Mine at 68 is a mild reduction. It's worth monitoring. Now, why might it be mildly reduced? High blood pressure is one, high strain over time is another, and both of these are caused by the substances that I take. My one kidney marker that's off the charts is creatinine, but this is really normal for someone. So yeah, people who have more muscle mass, they exercise, they eat more protein, they're going to have a higher creatinine level, and this is also the result of his low EGFR result. Usually EGFR, which is the systemic kidney marker, this totality of your kidney function, that's calculated usually from creatinine, but because people who have more muscle, they exercise, they might have this inflated creatinine level that can give the false impression that his kidneys are unhealthy. Now, this creatinine level is, even though it's normal for people who exercise to have it slightly higher, his result of 1.4 milligrams per deciliter is, even for people who exercise, is way too high, in my opinion. Even for people who eat a lot of protein, they even take creatine as a supplement. This result is quite worrisome, and probably the result of significantly higher amounts of muscle mass than he has compared to even the regular gym goer, and compared to the strenuous exercise that he does, compared to the average gym goer, and obviously because of the performance-enhancing drugs that he's taking. The optimal creatinine level, that can be debated. Yes, if you are exercising, that can be slightly higher than the optimal range, but personally, what I find the best creatinine level would be something like 0.8. It shouldn't definitely be over 1 milligram per deciliter. I prefer to have it 0.8 to 1. That's the sweet spot, in my opinion. I'm relatively muscular in the sense of compared to the average person. I also exercise quite regularly compared to the average person, or more so than the average person. I eat more protein than the average person. I don't take creatine all the time, but I do take it every once in a while, and my creatinine is usually something like 0.8, 0.9, 0.95 at the most. That's my sweet spot. If you have very good kidney markers, as measured with Cystatin C, which is a much better kidney marker than creatinine, then you would still have more optimal creatinine levels. Someone who might have good exercise, good muscle mass, their creatinine would still be in the normal range. If the creatinine is too high, like 1.2 or over 1.2, then it just means that despite the fact that you are exercising or eating a high protein diet, there could be something else that actually harms your kidneys, or your kidneys could be actually under a lot more pressure than they should. Looking at the Cystatin C is going to be more useful, but the creatinine, even in people who exercise and even in people who have more muscle, it shouldn't be insanely high. It shouldn't be 1.2 in my opinion. Next up, the liver. The two major enzymes we talk about are ALT and AST. My ALT at 160 and my AST at 70 are increased significantly. As I said in the beginning, the liver enzymes are going to be worse from performance enhancers, and yes, ALT of 160 is way too high. The optimal ALT somewhere less than 30 at least, so something between 10, more likely it's going to be like 15 for most people. 15 to 25 is kind of a healthy range. His result is several fold higher than that through the breakdown of these PEDs that his liver has to go through. Usually supplements are not going to do that. If you take some, I don't know, NAC or some ashwagandha or curcumin, unless that supplement is contaminated with heavy metals or something else like that, then it's not going to raise your liver enzymes. Some supplements will even help you with liver enzymes like NAC, but the performance enhancer drugs, they're going to be much more damaging to the liver. It's under a greater amount of burden. AST 70, so that would also be somewhere between 15, 25, and his is 70, which is several fold higher. One thing about the kidney markers is that he didn't mention that he measured cystatin C, which I said would be better to measure than just creatinine. For optimal kidney health, you want to measure cystatin C and creatinine, and then calculate your EGFR from cystatin C as opposed to creatinine. That would be the more complete picture of someone's kidney function. I would predict that his cystatin C would be slightly higher than a person who doesn't take performance enhancers, but I wouldn't think that his cystatin C would be as high as his creatinine compared to the reference range. It might be slightly above the reference range because of the PEDs, but because he's exercising still regularly, his cystatin C wouldn't be insanely high as his creatinine is. For the liver enzymes, alkaline phosphatase is another marker that would be worthwhile to measure, and GGT as well. There's ASD, ALT, GGT, and ALP, alkaline phosphatase. Those would be the more comprehensive liver panel. This is choosing a performance outcome over a health outcome. We then have Billy Rubin. Billy Rubin at 0.5 shows normal liver function, or at least no obvious liver dysfunction. Yes, his Billy Rubin result was in the normal range. So Billy Rubin can be like an antioxidant. I suspect that this is going to be normal because of the exercise component that he exercises still regularly despite taking performance-enhancing drugs. Yes, more the ALT, ASD, GGT, those are more susceptible to the harmful effects of performance-enhancing drugs as biomarkers rather than Billy Rubin. I had my two-year-old daughter and seven-month-old daughter cheering me on at World's Strongest Man this year. Once you have kids, you think about these things so differently. I never thought about mortality. I never really thought of my blood lipids. I never really cared. I just thought, you know, like, if I'm doing something, if I win World's Strongest Man and it causes me to die, it's not really that big of a deal because I've done something with my life that very few people could ever say. But once you have little ones and you watch them grow up and you just think, like, the amount of guidance that you feel like you'd be able to pass on to them. That's definitely the important point to remember people don't want to die, especially if they have children or family members. They usually would like to live longer once they have a reason to live for. And in most cases, it's going to be family or kids or grandchildren. And, you know, he's still quite young. He's actually one year younger than me. So both of us are born in September. He's just one year younger than me. And, you know, despite being, you know, young, he's 30 right now, I think, it's still obviously at the back of his head that he's sacrificing his health through the use of these performance enhancing drugs. It doesn't mean that he's going to die in the next 10 years or something. But if you are using performance enhancing drugs, then it will predictably shorten your lifespan unless you do some really comprehensive, I guess, repair or like the anti-aging side of things that when you stop using performance, let's say he quit, he retires, let's say around 40, then he needs to put a lot of work into healing his body and recovering from the use of this performance enhancing drugs. So it's good that he's measuring these things. He knows the history that, okay, I know from the use when I was using the heal test and whatever else he's using, he knows that, okay, this was my blood work back then. And that applies to also like normal people like you and I, you should have a backlog of some blood work and other biomarker data from your past history because then you know from the future, you can go back at it and see where did the things go wrong. Like if you, let's say, start to develop diabetes or kidney disease or some other liver disease, et cetera, you can see the trend line. You can see if things are getting worse or if things are getting better. And if you're proactive about it, then you would already take the course correction. You would already improve your health and you would try to improve these biomarkers. It's very powerful to actually be aware of the biomarkers because if you're not aware of them, you never measure your biomarkers, then you don't have even an idea of what is wrong or if there is something wrong or if you're heading in the wrong direction. If he sees right now his liver enzymes are high, his creatinine is very high, if he wasn't a professional strongman, he would obviously, if he wants to do good for his longevity, he would stop using the PEDs. He would start to course correct his health routines. He would lose a lot of weight. He would lose a lot of muscle in the process because he's carrying too much muscle. And he would also clean up his diet, do all these things to reverse the damage and improve his health to try to get these markers back into a normal range as a beginning and then try to get them more towards an optimal range. We'll start with the good. Glucose and HbA1c, the two glucose control. And yeah, as I predicted, I said in the beginning that his blood sugar levels are probably going to be quite optimal because he has a lot of muscle, which is a glucose sponge. He also exercises resistance training, which burns glycogen and improves his insulin sensitivity. So his glucose markers are actually quite excellent. So the fasting glucose 74, that's on the low end of the reference range, which means that his body just burns through a lot of glucose and liver glycogen in his sleep. So over the course of the night, he's in a faster state. Blood sugar goes quite low, which is a good sign that his body doesn't have any incident resistance or anything like that. His hemoglobin A1c, average blood sugar, glycated hemoglobin 5.1. So that is very good. If he wasn't using PEDs and if he wasn't probably eating a ton of carbohydrates and calories, then his hemoglobin A1c would probably be even like 4.8, 4.9. 5.1% for someone who is using PEDs and who is eating a lot of calories and food and is carrying excess body fat, 5.1 is an excellent result. The average person might have something like 5.4, 5.5%. The prediabetes range is 5.7 or 5.8 usually. So a hemoglobin A1c of 5.1% is excellent for his condition. Personally, I would prefer to have the hemoglobin A1c of 5% or slightly below that, but that's like just very small details. The average person is going to be a 5.4, 5.5 and a slightly healthier person will have 5.2, 5.3. So his result is better than the average person, which, as I said, was to be expected because of the muscle and exercise component. Next up, my triglyceride and blood lipid profile. This is a mess. Triglycerides. All right. So the lipids, as I also predicted in the beginning, I said that his triglycerides were also going to be somewhat normal, although higher than what would be optimal because of the muscle and exercise component. So his incidence sensitivity is great because of muscle and lifting weights, the resistance training component. Triglycerides, 92 milligrams per deciliter. Optimal triglycerides would be less than 50, but the normal reference range is 0 to 150 milligrams per deciliter. Interesting with triglycerides is that historically the triglyceride reference range was even 300. They lowered it to 150 over the last few decades. The reason for that is because even higher triglycerides than what would be considered normal are still associated with increased heart disease and mortality risk. 92, I would say, is acceptable for someone who's in his condition. I wouldn't be worried about the metabolic health side of things. So 92 is excellent. If they were like 150 and above, then I would start to try to lower them or be more concerned. But 92 is acceptable. Optimally, it would be 50. If he stopped using PEDs, then his triglycerides would pretty rapidly drop to 50, I would expect. If he loses the weight as well, he loses the body fat. Now the other lipids, cholesterol, those are also expected to be higher because of the PED use and the damage on the liver or the burning on the liver. So it's not that bad. It's not familial hypercholesterolemia levels. So total cholesterol 252. VLDL 18 is actually a good result, which also ties to the incidence sensitivity side of things. So VLDL is one of the more atherogenic lipoproteins or types of cholesterol. LDL 202, which is high, but it's not familial hypercholesterolemia levels of high. So there's different opinions about what's optimal cholesterol for lowest heart disease, etc. For someone who is using PEDs, he's at a higher baseline risk of atherosclerosis and heart disease because of the higher inflammation, higher liver burden, etc. So for someone who is using PEDs, they would need to prioritize lower LDL because of the higher inflammation. Now there's different opinions. If someone who isn't using PEDs, what would be their optimal LDL level? I would still say like 100 or less is for most people is going to be a safe bet. 200 in his context with a high inflammation, which he probably will have. I haven't seen the CRP level, but because of the PEDs, his inflammation will probably be a little bit higher. So that's my two cents on this. HDL is a low 32, which also happens when you're using PEDs. HDL goes down, ABOB and LDL go up. Usually triglycerides also go slightly higher, but these are actually, as I said, in an acceptable range. Optimal HDL would be 50 to 60, 65 maybe. Too high HDL is also associated with heart disease. So too high HDL isn't necessarily good. Low HDL, so his result 32, that's because of the PED use. Normal or higher HDL works hand in hand with better insulin sensitivity. So this is just because of the PED use, not because of poor insulin sensitivity, as his other glucose markers were all quite optimal. This recipe leads to increased stress on your artery walls. Your LDLs can penetrate artery walls. You have an inflammatory response, your body attacks, it calcifies, and that's what causes plaque buildup. Plaque buildup decreases the ability for your blood to get around your body, particularly your heart. And so this blood lipid profile over a certain period of time will kill me. What he should do, in my opinion, is also measure ABOB and APOA. So his ABOB is probably going to be like 120, 130. So that would be higher than optimal. Optimal ABOB is going to be less than 100 at least and closer to less than 70. He is using PEDs, which increases inflammation and just increases the risk of atherosclerosis, endothelial dysfunction. So a high ABOB, high LDL in the context of this high inflammation will be, yes, over the course of many years and decades will increase his risk of heart disease. There's going to be very few performance-enhancing drug users who won't develop atherosclerosis. Only very genetically blessed people will be able to pull it off. So I would suspect that he has been competing for quite a long time, many years. He's been using PEDs at higher doses than normal for many years. So I suspect he probably has already some level of subclinical atherosclerosis. He should get a calcium scan right now. Maybe not the standard CT scan, but something like a photon counting CT scan. So that's going to look at the soft plaque and the hard plaque. It has a radiation element, but it's lower than a traditional CT scan. There's also the clearly scan that has much less radiation than the traditional CT scan, but it would be quite important for him to get a baseline measurement. Maybe he has done it and I don't know, but he should get it right now because in his 30s, he should know what his calcium score is right now. Because then he knows his future potential risk of getting a heart attack as well, because it's going to keep going up. Even if he stops using PEDs, the age-related accumulation of calcium can still occur and it takes a long time for him to repair the damage to his endothelium and kind of slow down the development of atherosclerosis. So he should measure his ApoB, measure all these other lipoproteins, but he should probably get both a soft plaque score and a hard calcified plaque score. Even if he doesn't have calcified plaque, he probably will still have the soft plaque, which hasn't calcified yet because he's in his 30s. But he's going to calcify in a few years once he's continuing to use performance-enhancing drugs in larger doses. The good thing with my heart though is everything else shows what's called an athlete's heart. Basically thicker walls, larger left ventricle, ejection fraction of how much does the blood actually squeeze out is above 50%, which sounds bad, but it's actually pretty decent, especially when you have a particularly large heart. And this is probably from a combination of marathon running in the past and short blood pressure spikes from high intensity lifting. This means that my heart's functioning really, really well, but there's a small problem with getting blood supply to part of the heart. It's not a clinical problem. He has a bigger heart, which you would expect from having also higher muscle mass and exercising. There's a controversy about the enlargement of the heart and whether or not it will increase the risk of arrhythmias in athletes later. Yes, some athletes, especially ultra endurance athletes, tend to have other heart-related problems later in life, but it also has obvious health benefits to a certain extent. Now, the issue is that his heart is large because of also using performance drugs and just being very muscular. So if a normal person has a slightly larger heart, that's not necessarily a bad thing because it still improves overall cardiovascular health and cardiovascular fitness and aerobic performance. A larger heart results in slightly lower resting heart rate. If you combine it with higher heart rate variability score, then that means your heart is working quite properly. I would be curious to see what his resting heart rate is. Because he's so large and because he's using performance-enhancing drugs, I would suspect that his resting heart rate probably is in the 60s or 50s. The more optimal resting heart rate is at least 45. Endurance athletes and athletes who are smaller in body size or leaner, less massive strongmen or powerlifters would have something like 35 to 45 is kind of the most sweet spot for resting heart rate. And HRV, heart rate variability, the variability in heartbeats higher is better. I would say a 50 plus HRV is going to be a good sign. If I were to predict, I would say it's probably going to be something like 30-40 because of the bigger neck size. So he's probably going to have some degree of sleep apnea because of the extra muscle mass and a bigger neck size, which can increase the risk of sleep apnea, which will lower his recovery in sleep and also lower his heart rate variability. I checked in the rest of this video, he's not talking about any biomarkers. So he's just talking about the testosterone use thing that if you are using testosterone, then it's going to suppress your natural testosterone production. And if you're young, then that can obviously lead to fertility issues as well. So yeah, that's also very important to keep in mind. On social media, it's very commonplace nowadays to talk about using steroids and performance-enhancing drugs. Young individuals might be more influenced to start using different types of performance-enhancing drugs because it's become normalized. It's not as stigmatized as even 10 or 20 years ago. So yeah, I definitely agree with him that unless you're some competitive athlete, then don't try to use testosterone or some other performance-enhancing drugs unless you have a medical condition that results in lower testosterone. Try to optimize your natural testosterone and postpone the use of TRT, testosterone replacement therapy, for medical reasons as long as possible unless you have some medical condition that even younger individuals nowadays suffer more and more from. I'm not interested in ever using any performance-enhancing drugs because the risk or the downside to longevity is not worth it, even though you will obviously have a lot more strength or other performance metrics. I'm more interested in the longevity side of things, which is why I'm not even that convinced of TRT, at least not until the age of something like 70. Many people nowadays jump on TRT in their 40s. I probably won't need it and I'll wait as long as possible. I'll wait maybe at least until 60s or 70s if I need it even at that age. But before that, for most people, what performance-enhancing drugs will do is increase their liver enzymes, worsen their lipid profile, worsen their kidney markers, potentially worsen their glucose metabolism. But in his case, that's not the case. He's managing his glucose and insulin sensitivity quite well. His only limitations, his biggest red flags are his liver enzymes, some of his creatinine, and I would prefer him to measure the cystatin C. He didn't mention CRP, at least I didn't see it in the video, so I would suspect it's higher. CRP for optimal longevity would be as close to zero as possible. If I were to guess, then he would probably have a CRP of over 1 mg per liter because of the performance-enhancing drug use, but optimal CRP as low as possible. Alright, thanks for watching. Thanks to Mitchell for making the video. I'll put the original link to the video down below as well. On that, thanks for watching. If you want to discover your health percentage and get your roadmap to top 1% of health, then join the community using the link in the description. I'll see you there.