Health Assessment Report
ExamplePerformance panel · 10 biomarkers
Patient details
- Name
- Daan Willems
- Gender
- Male
- Age
- 33 years
- Date of birth
- 17-05-1992
Test details
- Test Date
- 16-06-2026
- Report date
- 19-06-2026
- Location
- Amsterdam Noord
- Laboratory
- Star-SHL
10
Total Markers
8
In Range
2
Needs Attention
Overall Assessment
This is a strong profile. Testosterone, IGF-1, HbA1c and fasting insulin all sit in the upper part of their range or comfortably within it, consistent with steady training and good metabolic conditioning.
Two values need attention: your hsCRP is slightly raised and your ferritin is low. In an athlete at your training volume those two often travel together and are rarely a sign of disease — but they do determine whether you keep progressing or stall.
Key Findings
hsCRP slightly raised (3.9 mg/L)
AttentionAbove the 3.0 limit. In an athlete the most likely explanation is a hard training stimulus in the days before the draw. hsCRP rises after intense exercise and settles within a few days.
Ferritin low (24 µg/L)
AttentionBelow the 30 lower limit. Endurance athletes lose iron through sweat, foot-strike haemolysis and the gut. Below a ferritin of 30, oxygen transport measurably declines even while hemoglobin is still normal.
Metabolic conditioning is excellent
GoodHbA1c 32 mmol/mol and fasting insulin 4.1 mU/L. This combination indicates high insulin sensitivity and is better than the average 33-year-old's.
Testosterone and IGF-1 in the upper part of their range
GoodTestosterone 22.4 nmol/L and IGF-1 28.6 nmol/L. There is no hormonal indication of overtraining or insufficient recovery.
Detailed Analysis
Hormones
NormalTestosterone 22.4 nmol/L and IGF-1 28.6 nmol/L. Both sit in the upper part of their reference range.
This is the pattern you want under heavy training: a falling testosterone or IGF-1 is one of the first hormonal signals of chronically insufficient recovery. There is no sign of that here.
Metabolic
NormalYour HbA1c is 32 mmol/mol, reflecting an average blood glucose over the past two to three months well below the upper limit. Your fasting insulin of 4.1 mU/L is low-normal.
A low HbA1c combined with a low fasting insulin indicates high insulin sensitivity. That is precisely what training acts on.
Inflammation
AttentionYour hsCRP is 3.9 mg/L, above the 3.0 limit. This test measures low-grade inflammation and is sensitive enough to pick up a single hard training session.
A single raised value in an athlete is therefore often training-related. If it stays raised after a few days of rest, it warrants further investigation.
Minerals
AttentionYour ferritin is 24 µg/L, below the lower limit of 30. For the general population 20 is often used as the floor, but 30 applies to endurance athletes because performance starts to suffer below that.
Your hemoglobin of 9.1 mmol/L is still normal. That is the usual picture: the store runs down before transport is affected.
Liver
NormalYour ALT is 41 U/L, just within range. In strength athletes a mildly raised ALT is often of muscle rather than liver origin; a CK measurement distinguishes the two when in doubt.
Recommendations
Repeat hsCRP after three rest days
Schedule the repeat after at least three days without intense training. If the value normalises it was training-related. If it stays above 3.0, discuss it with your GP.
Get ferritin above 40
Raise iron intake through diet and combine it with vitamin C. Do not take an iron supplement without advice: with a normal ferritin, supplementing does more harm than good, and in endurance athletes the cause of the loss is usually investigated first.
Retest after eight to twelve weeks
Ferritin responds slowly. Retest ferritin and hemoglobin after eight to twelve weeks, at a point with a comparable training load to now.
Next Steps
Schedule the hsCRP repeat after a short rest period and the ferritin check in eight to twelve weeks. Keep the training load around the draw comparable, or you will be comparing two different situations.
Contact your GP if the hsCRP stays raised, or if fatigue persists despite a normal ferritin. This report does not replace a consultation.
Your Test Results
Hematology
1What It Measures
Haemoglobin (Hb) is the iron-containing protein in your red blood cells that binds oxygen. It picks up oxygen in your lungs, carries it around your body, and takes carbon dioxide back on the return trip. This test measures how much haemoglobin is present per litre of blood. In the Netherlands the result is usually reported in mmol/l; internationally g/dl is more common. The value is measured as standard within the complete blood count. Because almost all the oxygen in your blood is bound to haemoglobin, this value tells you directly how much oxygen your blood can carry. Your doctor will therefore almost always assess haemoglobin together with haematocrit, the red cell count and MCV.
Lifestyle Tips
Dietary iron is the foundation: red meat, legumes, wholegrain products and dark leafy greens. Vitamin C with a meal improves the absorption of plant-based iron, while coffee and tea inhibit it. Do not start iron supplements on your own initiative. Supplementing without a demonstrated deficiency is not useful and too much iron can be harmful; have your ferritin measured first. Drink enough before a blood draw: dehydration concentrates your blood and can artificially raise the result. A persistently low or high value should always be investigated by a doctor, because the underlying cause matters more than the number itself.
Hormones
2What It Measures
This test measures the total amount of testosterone in your blood, reported in nmol/l. It includes both testosterone bound to proteins like SHBG and albumin, and the small fraction of free, unbound testosterone available for immediate use.
Lifestyle Tips
Regular resistance training, adequate sleep, stress management, and a balanced diet with sufficient zinc and vitamin D may support healthy testosterone levels. Limiting alcohol consumption could also be beneficial. Consult your healthcare provider for personalized guidance.
What It Measures
This test measures the concentration of IGF-1 in your blood. IGF-1 is produced primarily in the liver in response to growth hormone stimulation and mediates many of the growth-promoting effects of growth hormone throughout the body.
Lifestyle Tips
Adequate sleep, regular physical activity, and balanced nutrition may support healthy IGF-1 levels. Strength training and sufficient protein intake are often associated with optimal growth factor activity. Consult your healthcare provider for personalized guidance.
Inflammation
1What It Measures
This test uses a highly sensitive assay to detect low concentrations of CRP that standard CRP tests cannot measure. It reflects subtle, chronic inflammation associated with vascular health.
When Levels Are High
Elevated hs-CRP may not cause direct symptoms but indicates chronic low-grade inflammation that may contribute to cardiovascular disease over time.
Lifestyle Tips
Regular exercise, a Mediterranean-style diet, maintaining a healthy weight, and not smoking may help lower hs-CRP levels. Stress management and adequate sleep also contribute to reducing chronic inflammation.
Kidney
1What It Measures
Your eGFR estimates how many millilitres of blood your kidneys filter each minute. The e stands for estimated. The value is calculated rather than measured directly. The laboratory enters your creatinine, age and sex into an equation.<br><br>The standard equation is CKD-EPI. Its 2021 version deliberately works without a race coefficient. Older equations did apply one. They overestimated kidney function in Black patients and delayed referral. Some European laboratories also use the EKFC equation. CKD-EPI and EKFC can differ slightly in the same person. Check which equation your report names.<br><br>The figure is scaled to a standard body surface area of 1.73 square metres. It answers what your filtration would be at an average body size. For a very large or very small body the true filtration differs.<br><br>Creatinine comes from muscle tissue. Muscle mass therefore affects the result. Men on average carry more muscle than women. That is why sex appears in the equation. In a woman with little muscle the eGFR can look better than her kidney function truly is.
Lifestyle Tips
Protect your kidney function by managing blood pressure and blood sugar levels within healthy ranges. Stay well hydrated and maintain a balanced diet that is not excessively high in sodium or protein. Engage in regular physical activity, maintain a healthy weight, and avoid smoking. Limit the use of over-the-counter pain medications, particularly NSAIDs, which can damage the kidneys over time. Always discuss medication use with your healthcare provider.
Liver
1What It Measures
The test measures how much ALT is circulating in your blood. The result is given in units per litre, abbreviated u/l. ALT stands for alanine aminotransferase.<br><br>Older reports sometimes carry the former name SGPT. It is the same enzyme and the same measurement.<br><br>The enzyme works inside the cell. It moves an amino group between two compounds. Your body needs that step to convert amino acids into fuel.<br><br>As long as a cell is intact, the enzyme stays inside it. Only when liver cells are damaged does ALT leak out.<br><br>Where ALT sits determines what the result is worth. The enzyme is concentrated mainly in the liver, far more than anywhere else. Small amounts sit in kidney, heart and skeletal muscle. That distribution makes ALT more liver-specific than AST, which occurs in many tissues at once.<br><br>This is why ALT rarely appears alone on a report. You usually see it beside AST, gamma-GT, alkaline phosphatase and bilirubin. Each enzyme points in a different direction.<br><br>ALT and AST come from the liver cell itself. Gamma-GT and alkaline phosphatase come from the bile ducts. That split guides the further investigation a doctor chooses.<br><br>The measurement itself says nothing about the cause. It only adds up how much enzyme is circulating. What a high ALT value means becomes clear only alongside the other liver values.
Lifestyle Tips
The biggest gain usually sits with weight, not with a supplement. Fatty liver is the most common reason for a mildly raised result in the Netherlands. Gradual weight loss combined with regular exercise is the best-supported approach.<br><br>A fall of roughly seven percent of body weight usually brings liver values down clearly. Do not expect an effect within a week.<br><br>Alcohol is the second dial you can turn. Heavy alcohol use burdens the liver directly. A period without alcohol often shows, on a repeat measurement, how much of the result was attributable to drink.<br><br>Sugar and fast carbohydrates deserve separate attention. Fructose from soft drinks and juices contributes to fat accumulation in the liver. That is a structural route, not a day-to-day one.<br><br>Go through your medicines and supplements with your GP or pharmacist. Include over-the-counter products and herbal preparations. Never stop a prescribed medicine on your own initiative because of a blood result. Discuss it first.<br><br>Finally, schedule the draw sensibly. Leave 48 to 72 hours after a heavy or unaccustomed training session.
Metabolic
2What It Measures
This test measures the percentage of haemoglobin in red blood cells that has glucose attached to it. Higher percentages indicate higher average blood sugar over the preceding months.
Lifestyle Tips
Consistent carbohydrate management, regular physical activity, maintaining a healthy weight, and managing stress are key to keeping HbA1c within a healthy range. Small, sustained changes are more effective than drastic diets.
What It Measures
This test measures baseline insulin levels in a fasting state. Elevated fasting insulin often precedes elevated fasting glucose, making it an early indicator of metabolic dysfunction.
Lifestyle Tips
Regular exercise, especially resistance training and aerobic activity, can improve insulin sensitivity. Reduce refined carbohydrates, prioritise protein and fibre, and maintain a healthy weight.
Minerals
1What It Measures
Ferritin is a protein that stores iron. Each ferritin molecule can bind and safely store a large number of iron atoms, mainly in the liver, the spleen and the bone marrow. A small fraction of that ferritin leaks into the blood, and that fraction is what the test measures. Your ferritin level is therefore a reflection of how much iron your body has in storage. That makes ferritin different from the other iron values. Serum iron shows how much iron is circulating in your blood at the moment of the draw, a figure that swings considerably across the day and after a meal. Transferrin is the transport protein that carries iron through the blood, and transferrin saturation indicates what share of that transport capacity is actually occupied. Ferritin answers how much iron you hold in reserve, not how much is in transit. Results are reported in micrograms per litre (µg/l). The band below is the reference range of the laboratory that performs our tests. <table><thead><tr><th>Group</th><th>Reference value</th></tr></thead><tbody><tr><td>Men</td><td>30 – 400 µg/l</td></tr><tr><td>Women</td><td>15 – 150 µg/l</td></tr></tbody></table> The lower limit sits lower in women because the reference population it was derived from includes menstruating women, who lose iron structurally. It describes what is common in that group. It is not a statement that a smaller reserve is desirable or healthy in women. Two national bodies, the Dutch society for clinical chemistry and the hereditary haemochromatosis guideline, deliberately decline to publish a universal ferritin reference value. The reason is that the assay differs between laboratories, and the difference is not small: another platform uses 15 to 200 µg/l for men. Both therefore advise using the values of the performing laboratory. Always go by the reference values printed on your own report.
When Levels Are Low
An empty iron store often causes symptoms before anaemia develops. The most commonly reported are persistent fatigue that sleep does not resolve, breathlessness on exertion, dizziness, headache, cold hands and feet, pallor, brittle nails, hair loss and restless legs. Difficulty concentrating and reduced stamina are also described. Each of these complaints is non-specific and can have dozens of other causes, so on their own they prove nothing. They are, however, a good reason to have your iron status measured rather than wait. In men, and in women after the menopause, a low ferritin always requires an explanation, because menstrual blood loss falls away as a cause. Discuss this with your doctor.
Lifestyle Tips
How much iron you absorb from your diet depends more on the form than on the quantity. Haem iron from meat, fish and poultry is absorbed considerably better than non-haem iron from plant sources such as pulses, wholegrain products, nuts and dark green leafy vegetables. Anyone eating little or no meat therefore obtains iron mainly in the less absorbable form, and that is one reason stores can decline slowly without anything unusual being wrong. What you eat alongside it shifts absorption measurably. <strong>Vitamin C</strong> clearly increases the absorption of non-haem iron, so including a source of vitamin C with a plant-based meal is a simple and effective habit. The reverse also exists: the tannins in tea and coffee and the calcium in dairy inhibit absorption when taken with the same meal. Having tea or coffee an hour before or after eating rather than with it is a worthwhile difference for people with limited stores. Do not take iron supplements on your own initiative. Iron accumulates with untargeted intake, and supplementing without a demonstrated deficiency can be harmful. Whether supplementation is needed, in what form and for how long, is a decision for your doctor based on measured values. If your ferritin stays low despite adjustments, or is repeatedly raised, have the cause investigated rather than correcting it yourself.
Vitamins
1What It Measures
<p>This test measures <strong>25-hydroxyvitamin D</strong> (25-OH-D) in the blood. That is the storage form of vitamin D. It is also the only form that says anything about your reserve. The result is reported in nmol/l.</p><p>25-OH-D has a half-life of two to three weeks. The result therefore reflects supply over the preceding months, not yesterday.</p><p>The active form is called 1,25-dihydroxyvitamin D. It is deliberately <em>not</em> measured. It has a half-life of hours and is tightly regulated by parathyroid hormone (PTH).</p><p>When stores run low, the body increases the conversion. The active value can then look normal, or even raised, while the reserve is empty. Ordering the 1,25 form for a suspected deficiency is the classic clinical mistake.</p><p>The report should give total 25-OH-D, meaning D2 plus D3. That matters for anyone taking a plant-derived D2 product. Some immunoassays under-recover D2.</p>
Lifestyle Tips
<p>The Netherlands sits at roughly 52 degrees north. From October through March the sun is too low here. Too little UVB (290 to 315 nm) reaches the skin. Through those months there is effectively no endogenous production, and the body draws on its summer reserve.</p><p>The month of the blood draw is therefore part of the result. A March value is not comparable with a September value. A fall between the two is usually the season, not a deterioration.</p><p>A lower value is expected with:</p><ul><li>darker skin, because melanin absorbs UVB and more exposure time is needed</li><li>covering clothing</li><li>indoor work and night shifts</li><li>obesity, because vitamin D is sequestered in adipose tissue</li><li>older age, because the skin holds less of the precursor</li><li>fat malabsorption</li><li>enzyme-inducing medication such as anticonvulsants and rifampicin</li><li>glucocorticoids, which accelerate breakdown</li></ul><p>The Dutch Health Council advises certain groups to supplement:</p><ul><li>people aged seventy and over</li><li>pregnant women</li><li>people with darker skin</li><li>people who get little daylight</li></ul><p>What amount fits is a question for the GP or the Voedingscentrum.</p><p>Do you take high-dose biotin? Mention it when the sample is drawn. Biotin can interfere with some 25-OH-D immunoassays and push the result falsely high.</p>
Assessed by a BIG-registered doctor
This report was prepared by a BIG-registered doctor. It does not replace a personal medical consultation. Always consult your general practitioner if you have questions.