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High Hemoglobin A1C: What it is and why it matters

High Hemoglobin A1C: What it Means and Why it Matters

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The Good News is Diet and Lifestyle Can Influence Your Number

You’ve started the year off with a healthy mindset and scheduled your annual doctor’s appointment to review your blood tests.

At the appointment, the doctor says your numbers look good … except your hemoglobin A1C is 5.7 and higher than ideal. You’ve officially crossed over into the “pre-diabetes” diagnosis. Now you’re wondering:

  • What does it mean to have a high hemoglobin A1C?
  • Does it matter if I’m not diagnosed with Type 2 diabetes?
  • How can I lower my hemoglobin A1C without medication?

What is Hemoglobin A1C?

There are a few steps to understanding your hemoglobin A1C level.

Hemoglobin A1C is related to the level of glucose found in your blood.

Ideally, the food we eat is broken down into nutrients, including glucose. Glucose enters the bloodstream, attaches to insulin and is brought into our cells to be used as energy. That energy powers your body – your heart, lungs, muscles, brain, etc.

Another important molecule in our blood is hemoglobin. Hemoglobin lives in our red blood cells and is best known for collecting oxygen and delivering it to tissues around the body. However, hemoglobin may also attach to glucose where it becomes “glycosylated hemoglobin.”

Glucose attaching to hemoglobin isn’t a problem when glucose levels are moderate. But when there’s excess glucose in our blood, it can override oxygen and create more glycosylated hemoglobin. Excess glycosylated hemoglobin in our blood may indicate long-term high blood sugar which can lead to diabetes, cardiovascular disease, and organ damage.

The hemoglobin A1C blood test shows the proportion, or percentage, of your blood that is glycosylated hemoglobin. Therefore, a result of 5.0 means that 5% of your hemoglobin is attached to glucose, and this level has been consistent for 2-3 months.

What it Means to Have a “High Hemoglobin A1C”

According to the American Diabetes Association, an official diabetes diagnosis consists of two hemoglobin A1C test results greater than or equal to 6.5%. An official “prediabetes” diagnosis is an A1C greater than or equal to 5.7% and less than 6.5%. Research shows that maintaining a consistent A1C below 5.7% lowers the risk of diabetes-related conditions and diseases.

From a holistic nutrition approach, we look at several blood markers as indicators of glucose balance and metabolism, including fasting glucose and fasting insulin as well as A1C. We see that an A1C result of 5.4% or below is an indication of good blood glucose control.

Why It Matters to Reduce Your Hemoglobin A1C

According to a 2022 review, consistently high and uncontrolled glucose levels can impact your kidneys, eyes, nerves, and cardiovascular system.  “[Diabetes] is considered one of the fastest-growing public health emergencies globally.” I won’t belabor the point here, so you can read more about the complications of diabetes at the ADA’s web site.

High hemoglobin A1C levels may also have nutritional implications. High A1C can impact nutrients levels and nutrients levels lead to high A1C. Either way, uncontrolled blood glucose can be a contributing factor for fatigue.

Warning Signs of Prediabetes or High Hemoglobin A1C

Not every person exhibits the symptoms of diabetes, so it’s important to know and track your A1C level, alongside other inflammatory markers and nutrient status. Some people may show general signs such as darkened skin in the armpit or the back and sides of the neck. Skin tags and eye changes are also signs. Even more common is weight gain especially around your mid-section and low energy. Getting regular blood tests can keep you apprised of your levels and avoid surprises.

Risk Factors Associated with High Hemoglobin A1C

According to the Mayo Clinic, the same risk factors that impact a Type 2 diabetes diagnosis also increase the risk of elevated A1C and prediabetes. The risk factors are:

  • Weight – specifically fatty tissue around abdomen and in and between muscles;
  • Waist Size – the risk increases for men with waists larger than 40 inches and 35 inches for women;
  • Inactivity
  • Age – the risk increases after age 35
  • Sleep – disrupted sleep, especially from conditions like sleep apnea
  • Smoking
  • Other health conditions – High blood pressure and low HDL cholesterol levels
  • Diet – frequent eating of highly processed, highly refined carbohydrate foods

Can Diet Help Me Lower My Hemoglobin A1C?

Knowing you have a high A1C can be viewed as a “reset” button. Research shows that even a modest weight loss of 2.5 to 10% can improve the risk of impaired glucose tolerance.

Here are some simple ideas to get you started:

  • Decrease your consumption of highly processed carbohydrates as they quickly turn into glucose. All carbohydrates (vegetables, fruit, beans, grains, sugar, alcohol) are broken down into glucose. However, carbohydrates that lack fiber (think flour-based grains like bread, fruit juices, soda, sugar, and alcohol) are broken down into glucose very rapidly and can increase blood glucose levels.
  • Refrain from sugar and sugar alternatives. This includes soda, shakes/smoothies and sweetened coffee creamer. Avoid ending your day with desserts and sweets.
  • Start and end your day with protein, vegetables, and healthy fats. These foods help keep your blood glucose levels steady.
  • Increase fiber. Fiber counteracts and slows down blood glucose spikes. Eat a variety of whole fruits (not juice), vegetables, and beans. A 2013 meta-analysis study consisting of 605 diabetes patients showed a diet high in fiber reduced both glycated hemoglobin and fasting blood glucose values.
  • Change the type of sugar you’re consuming. Instead of reaching for sugary drinks and processed foods, choose low glycemic fruits, like berries and melons, in moderation. These still have a sweet taste, but since you’re eating the whole food, you’re getting the added benefit of natural fiber, which is also great for digestion.
  • Move. There’s no need to create a complicated exercise program. Simply start by taking more steps today than you did yesterday. Tomorrow, take more steps than you did today and so on. Moving helps to “re-move” stored glucose from our muscles so it can be eliminated from the body. Taking a walk after a meal is a great way to help your body process glucose. 
  • Hydrate with Water. Excess glucose needs to be flushed from the body and plain water is the best way to help your kidneys remove it. Keep it simple: Buy a large water bottle and drink 2 – 3 bottles/day.

Frequently Asked Questions about High Hemoglobin A1C and Prediabetes:

  • What is the A1C test used for?
    • The hemoglobin A1C test is used to show the percentage of glycosylated hemoglobin in your blood or the amount of glucose attached to the hemoglobin consistently over a 2 – 3 month period.
  • What is a healthy A1C level?
    • According to the American Diabetes Association, a “normal” A1C level is below 5.7. From a holistic nutrition perspective, we consider a healthy A1c at 5.4 or less.
  • What are the symptoms of being pre-diabetic?
    • There really are no outright symptoms of prediabetes, which is why getting regular bloodwork is important. Some general signs of uncontrolled blood glucose are darkened skin areas in the armpit or back and sides of your neck, skin tags, and eye changes. Some people notice weight gain and fatigue. But these symptoms are not found in everyone with an elevated A1C or prediabetes diagnosis.
  • How do I lower my A1C quickly?
    • To better control blood glucose and lower A1C levels, we recommend decreasing the amount of sugar and sweeteners consumed daily, eating more fiber, protein and healthy fats as well as moving regularly and drinking plenty of water.
  • Does prediabetes go away?
    • Yes, research shows that A1C levels can be reduced. Even a slight reduction in weight of 2.5 to 10% and regular movement can reduce the risk of progression by 50%.
  • What foods should a prediabetic avoid?
    • Anyone with an elevated A1C marker would benefit by avoiding highly processed foods with added sugar and artificial ingredients. It’s also a good time to limit refined carbohydrate foods such as sugar, soda, fruit juice, bread, pasta and baked goods, and avoid fried foods.

Balance Your Blood Sugar Nutrition Guide

Do you have cravings for sugar or carbs during the day or right after a meal? Do you take the concept of hangry (hungry-angry) to an all-new level? Has your doctor said your glucose level is too high, you need to lower your carb intake, or to avoid “white foods”? If this sounds like you, your blood sugar could be out of balance. We can help you learn how to get off the rollercoaster and keep your energy levels stable.

Balancing blood sugar is important for so many aspects of your health. Our free guide provides you with simple tips for avoiding the blood sugar spikes and drops, banishing cravings, and keeping your energy levels stable. Download now to receive:

  • Our 9 top rules for balancing blood sugar
  • The magic combo to keep you feeling full longer and reduce snacking
  • Rollercoaster-inducing foods to avoid
  • Delicious recipes for every meal of the day

If you, or someone you know, are struggling to lower A1C but keep coming up short, schedule a phone consultation with us today to see how we can help. We’ll address all your questions, from diet and lifestyle strategies to medication support and glucose monitors.

We have many ways to support you and it is never too late to start improving your health!

Another marker that can be significant in your health journey is glucose. For more information about wearing a continuous glucose monitor (CGM) and monitoring your glucose levels, read this post.

Resources:

Nascimento ALA, Guimarães AS, Rocha TDS, Goulart MOF, Xavier JA, Santos JCC. Structural changes in hemoglobin and glycation. Vitam Horm. 2024;125:183-229. doi:10.1016/bs.vh.2024.02.001

Ortiz-Martínez M, González-González M, Martagón AJ, Hlavinka V, Willson RC, Rito-Palomares M. Recent Developments in Biomarkers for Diagnosis and Screening of Type 2 Diabetes Mellitus. Curr Diab Rep. 2022;22(3):95-115. doi:10.1007/s11892-022-01453-4

Ryan DH, Yockey SR. Weight Loss and Improvement in Comorbidity: Differences at 5%, 10%, 15%, and Over. Curr Obes Rep. 2017;6(2):187-194. doi:10.1007/s13679-017-0262-y

https://diabetes.org/about-diabetes/diagnosis

https://www.mayoclinic.org/diseases-conditions/prediabetes/symptoms-causes/syc-20355278

https://my.clevelandclinic.org/health/diseases/21498-prediabetes

Flávia M Silva, Caroline K Kramer, Jussara C de Almeida, Thais Steemburgo, Jorge Luiz Gross, Mirela J Azevedo, Fiber intake and glycemic control in patients with type 2 diabetes mellitus: a systematic review with meta-analysis of randomized controlled trials, Nutrition Reviews, Volume 71, Issue 12, 1 December 2013, Pages 790 – 801, https://doi.org/10.1111/nure.12076

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