Case three · VO2 max
Carmen
, 58
Lawyer, five days a week on the bike and no faster in three years. The hours were fine. The way she spent them was not.
Marker
VO2 max, ml/kg/min
Baseline to month 12
29 → 34
Twelve months of VO2 max
VO2 max · Carmen · 12 months
34
ml/kg/min at month 12, from 29 at baseline
ApoB
Kerno target
VO2 max in ml/kg/min, measured on the bike at baseline and at each retest.
Starting point
Lawyer, cycles five days a week, had stopped getting faster three years ago. Wanted to know why.
Month 0
Five days a week on the bike, no faster in three years.
What we found
VO2 max 29 ml/kg/min, average for her age and low for her volume of training. 80% of her riding sat between the two thresholds. Ferritin 22 ng/mL, low.
Baseline morning
VO2 max 29 ml/kg/min. Ferritin 22 ng/mL, low.
What we changed
Most riding moved below the first threshold. Two short sessions a week above the second. Iron replaced under her physician, ferritin retested at month three.
Month 1
Most riding moved below the first threshold. Iron started.
At 12 months
VO2 max 34, top quartile for women her age. Ferritin 61. Same hours on the bike, arranged differently.
Month 12
VO2 max 34 ml/kg/min. Ferritin 61 ng/mL.
Three markers, before and after
Fitness and iron · Carmen · month 12
Bar shows lab range, band shows Kerno target
VO2 max
Baseline 29
34
ml/kg/min
In range
Ferritin
Baseline 22
61
ng/mL
In range
Resting heart rate
Baseline 61
54
bpm
In range
Values at month 12, baseline under each name. All three now sit inside the Kerno target.
Other cases
ApoB
Marta,
52
Borderline LDL on a standard panel. Her particle count said act now.
132
→
78
mg/dL
↓ Down
Deep sleep
Daniel,
47
Nothing in his blood explained the fatigue. The overnight data did.
61
→
84
min per night
↑ Up
Blood pressure
Jorge,
61
The same blood pressure on half the medication. A flat line was the goal.
124
→
123
systolic, mmHg
→ Flat
