13 replies to this topic

[Ben]

Hi everyone.

I'm going to the doctor today and I like to get the following tested:

My cholesterol
Hormone levels
Other makers of overall health.

Which tests should I ask for specifically, and what type of tests should I insist on?

Thanks a lot.

[niner]

If you've not had them before, or in a while, you should get a 25-hydroxy vitamin D3 level. Another thing that I try to stay on top of is Hemoglobin A1C. This is a measure of glycation of a particular residue of hemoglobin, and it tells you how your blood glucose control has been over the previous three months or so. If you are non-diabetic, it is mainly influenced by your post-prandial glucose level. It's a cheap test and is far more meaningful than a fasting glucose level.

[rwac]

Are you generally healthy ?

Make sure you get LDL measured independently rather than calculated.

Vitamin D

A1c (Glycation: measures average blood glucose levels)

Ferritin (measures iron stores)

C-Reactive Protein (inflammation)
Homocysteine (CVD)

ALT/AST (Liver)

Creatine/BUN (Kidneys)

[s123]

Hi everyone.

I'm going to the doctor today and I like to get the following tested:

My cholesterol
Hormone levels
Other makers of overall health.

Which tests should I ask for specifically, and what type of tests should I insist on?

Thanks a lot.

I will also go for a blood test, probably this week. I will ask the following:

Glucose, HbA1c, insulin, cortisol, ACTH, IGF-1, DHEAs, renine, testosterone, T3, TSH, prolactin, androstenedione, LDL, LP(a), APO A1, APO B100, HDL, triglycerides, CRP (high-sensitive), fibrinogen, ceruloplasmine, hematocrit, sedimentation, blood count, G6PD, Na+, K+, Ca2+, Mg2+, Cl-, HCO3-, creatinine, alkaline phosphatase, AST, ALT, ferritin, transferin, B12, 25-hydroxy D3, urea, uric acid, LDH, gamma-GT, lipase, billirubin, and homocystein.

I put the most important tests in bold.

Edited by s123, 18 January 2010 - 05:43 AM.

[Ben]

Thanks for the replies dudes.

So I went to the doctor today. Guess what happened? After asking for most of the tests mentioned, here's how the conversation went:

"Look I don't really feel comfortable ordering these tests for you, especially the LDL subfractions"
"Ah, can I ask why?"
"Well... (long considered scholarly pause looking at the ceiling and stroking beard- a study of intellectuality) no one really does these tests. They're not really that important at all. They're really only a research thing." He says dismissively.
"Well, if you wouldn't mind, could you?"
"No"
"Ah, but you're a doctor, surely you can"
"Yes but the problem is, I can't really interpret these results. These are complex research bio markers. Honestly, they're not very useful. I normally just do a regular lipid panel."
"What about CRP or homocystein?"
"Again these are purely for research purposes only and don't serve much purpose otherwise."
"Is there anyone who could do this for me?"
"Maybe an endocrinologist or a cardiologist. You would have to ask one of these specialists."

So, I have a referral to an endocrinologist who will probably charge me just to breath the same specialist air that he does, and will probably mean me taking about a small mortgage on my car to cover the fees.

Bit crap.

[rwac]

Can you order your own blood tests online ?

http://www.lef.org/V...Blood-Test.html

[Ben]

Can you order your own blood tests online ?

http://www.lef.org/V...Blood-Test.html

I appreciate the link, and that's a good service, but it would actually be cheaper for me to see a specialist and get the tests done through him than pay $400 to the Life Extension Foundation.

I'm going to try again with another GP on Thursday. If I can get a non-specialist to order the tests for me I could potentially get everything done for free.

[s123]

"Yes but the problem is, I can't really interpret these results. These are complex research bio markers. Honestly, they're not very useful. I normally just do a regular lipid panel."

Very honest of him to admit that he doesn't know how to interpret these tests. It shows how low his knowledge of heart disease is, yet he probable treats a lot of patients who have it.

Good doctors are rare and I'm lucky to have found a Heales member who will graduate as doctor next year.

Edited by s123, 19 January 2010 - 03:19 PM.

[Ben]

"Yes but the problem is, I can't really interpret these results. These are complex research bio markers. Honestly, they're not very useful. I normally just do a regular lipid panel."

Very honest of him to admit that he doesn't know how to interpret these tests. It shows how low his knowledge of heart disease is, yet he probable treats a lot of patients who have it.

Good doctors are rare and I'm lucky to have found a Heales member who will graduate as doctor next year.

your lucky. And you're assumption is probably correct. I live in an area with a lot of elderly people. No doubt it's his main thing.

[rwac]

Very honest of him to admit that he doesn't know how to interpret these tests.

I would much prefer if the doctor ordered it anyway. Interpreting test results isn't quite brain surgery.

FYI Ben, you can get the blood test with membership for $344.

[Mia K.]

Hi everyone.

I'm going to the doctor today and I like to get the following tested:

My cholesterol
Hormone levels
Other makers of overall health.

Which tests should I ask for specifically, and what type of tests should I insist on?

Thanks a lot.

I will also go for a blood test, probably this week. I will ask the following:

Glucose, HbA1c, insulin, cortisol, ACTH, IGF-1, DHEAs, renine, testosterone, T3, TSH, prolactin, androstenedione, LDL, LP(a), APO A1, APO B100, HDL, triglycerides, CRP (high-sensitive), fibrinogen, ceruloplasmine, hematocrit, sedimentation, blood count, G6PD, Na+, K+, Ca2+, Mg2+, Cl-, HCO3-, creatinine, alkaline phosphatase, AST, ALT, ferritin, transferin, B12, 25-hydroxy D3, urea, uric acid, LDH, gamma-GT, lipase, billirubin, and homocystein.

I put the most important tests in bold.

I would include ferritin as one of the most important tests.  Regards, Mia

[sthira]

I'm going to try again with another GP on Thursday. If I can get a non-specialist to order the tests for me I could potentially get everything done for free.

This is what I was going to suggest -- go to another GP and ask for the tests you want. I also went to the doctor today and asked for blood tests, and she had no problem ordering whatever test I wanted. So I ordered many of the tests suggested here, and my doctor's only concern was whether insurance would pay for these tests or not. She ordered them for me anyway.

[nameless]

Can you order your own blood tests online ?

http://www.lef.org/V...Blood-Test.html

I appreciate the link, and that's a good service, but it would actually be cheaper for me to see a specialist and get the tests done through him than pay $400 to the Life Extension Foundation.

I'm going to try again with another GP on Thursday. If I can get a non-specialist to order the tests for me I could potentially get everything done for free.

It seems to really comes down to luck most of the time when getting tests... or so it seems to me. I've gotten the same sort of response where the doctor admits he/she doesn't know how to interpret the results. I've been lucky with my cardiologist and GP in the past, where even if they admit to not knowing how to interpret, they usually order anyway if I ask nicely.

A lot of it comes down to how friendly/open the doc is, and if they are willing to work with you. I even explained to one doctor that I'd show her how to interpret the results, which was fine with her.

Sometimes I think male doctors, on average (perhaps being more egocentric), are less likely to admit their lack of knowledge, or order tests they don't understand. So you get the: 'No, it's not needed', sort of response, rather than the 'I'm clueless, so I won't order it', reply.

Edited by nameless, 19 January 2010 - 09:13 PM.

[Skötkonung]

Frequently, the unwillingness to order these types of blood tests comes down to cost. In many health systems, physicians are held directly accountable for maintaining a low cost of diagnosis and treatment. In the United States, it would be the insurance companies who monitor for extraneous exams and tests, while in other countries it might be a regulatory body. Unless the physician suspects you have a underlying condition meriting these types of extensive lab work, he will be unwilling to issue them.

In my case, I wanted to test the dietary influence of several variations of high fat to high carbohydrate diets on my testosterone and IGF1 levels over a period of several months. I had two primary care physicians deny the tests, stating I obviously didn't need them as I am young and outwardly healthy. To get these tests done, I had to contact a friend at a local medical university.

Even when tests are required for an underlying health condition, it can be difficult to get them done. For instance, I have hemochromatosis diagnosed as being homoygous for the C282Y mutation. Every year or two, I have my TF saturation and ferritin measured to make sure my phlebotomy treatments are effectively keeping me from storing more iron. When I moved to Oregon (United States), my primary care physician (who is part of the Legacy group) would not prescribe the tests without paperwork documenting my positive diagnosis of hemochromatosis. It was a pain in the ass to track down the paper work and have it faxed to his clinic, and I had to make two trips to his clinic before I could even get my blood drawn.

Incidentally, my iron came back in the low range of normal and my doctor acted as if I had royally wasted his time. I think he should have been happy for me!

Edited by Skotkonung, 20 January 2010 - 12:55 AM.