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what tests

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pgf54
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what tests

Postby pgf54 » Thu Jan 01, 2015 7:16 pm

Hi I am going to get a few blood tests taken this month,with a new Dr in a new area. Small country town , which is like stepping back 50 years in time.
However I cannot afford to pay privately and probably cant get too many performed as prophylactic medicine is not to the forefront, and unless I am ill they wont justify the tests.
In fact the more I try and discuss with them'(tactfully) they either become threatened and defensive , or push what their beliefs are without really wanting to hear what I am trying to do.
In fact I still meet some who do not want to give you the results and say" all your results are normal "and I have to get real assertive to even get a copy of my own results. And as you know so many have such diverse opinions.
Many just want a quick consult, with a quick fix.ie I said to one Gp, I am not here for medication or time off work and his response was to snap "well what are you here for then?.............However I digress my question is I am going to ask for the following tests, does anyone think there are any others which are vital?, bearing in mind my limitations. ie if you could only add one or two more what would you add?
Fasting Insulin, lipids basic, homocysteine, hbA1c, Fbs, D3, lfts, U and E, Psa, Fbp............
Thanks Paul
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Ski
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what tests

Postby Ski » Thu Jan 01, 2015 8:29 pm

Paul - I think a basic lipids test won't tell you much with regards to risk without knowing your Sub fractions that an NMR provides.


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Stavia
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Re: what tests

Postby Stavia » Fri Jan 02, 2015 2:47 am

B12, liver functions, ferritin. TSH.
U & E not accurate enough and out of date. Its creatinine and elecs now, not urea and elecs.
What is fbs and fbp? If fbs is fasting blood sugar its just a snapshot and not that much value as a once off out of context. If yiu dont have to pay, may as well add it cos youll be fasting anyway.
If you have to pay for fasting insulin, you can save the money by using the surrogate markers of hba1c, TGs, signs of fatty liver in LfTS (I'll help you interpret them) and simply waist circumference to ascertain your insulin resistance.
Basic lipids are a good baseline. It will tell you your Tgs, HDL and give an idea of your LDL which is still a fairly accurate risk marker. We manage everything in my whole non-USA first world country on basic lipids alone with no worse health outcomes.
PSA is a whole can of worms in itself.
Homocysteine again if you have to pay yourself might not be good value for your money.

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pgf54
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Re: what tests

Postby pgf54 » Fri Jan 02, 2015 5:29 am

Thanks Ski and hello Stavia, I hope I didn't cause offence with my whinge about Gp's, probably unkind of me as I know how so many people just want a quick fix or a pill and find lifestyle changes too hard. I wouldn't do your job for the world, but I do wish I had a Gp like you Stavia , it would be amazing................
Anyway , yes I meant fasting blood sugar by fbs and full blood picture by fbp...........I know psa is controversial but my Dad has prostate cancer and I have rs6983267 GG in addition which increases my odds 1.6% or so promethease tells me.
I will get the suggested tests and see how it goes, but maybe later at the end of the month as I did eat a bit extra over the festive season. I do have a history of fatty liver, and metabolic syndrome, though have lost a considerable amount of weight since then. Thanks for the suggestions Paul
Don't wait for your ship to come in, row out to meet it.

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Re: what tests

Postby Ski » Fri Jan 02, 2015 7:33 am

Stavia wrote:B12, liver functions, ferritin. TSH.
Basic lipids are a good baseline. It will tell you your Tgs, HDL and give an idea of your LDL which is still a fairly accurate risk marker. We manage everything in my whole non-USA first world country on basic lipids alone with no worse health outcomes.

Stavia - what are your thoughts then on the statement that I think they say around 50% of heart attack patients have "normal" basic blood lipids?

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Stavia
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Re: what tests

Postby Stavia » Fri Jan 02, 2015 11:50 am

Ski wrote:
Stavia wrote:B12, liver functions, ferritin. TSH.
Basic lipids are a good baseline. It will tell you your Tgs, HDL and give an idea of your LDL which is still a fairly accurate risk marker. We manage everything in my whole non-USA first world country on basic lipids alone with no worse health outcomes.

Stavia - what are your thoughts then on the statement that I think they say around 50% of heart attack patients have "normal" basic blood lipids?


Absolutely agree Ski, I was trying to help with budgeting and apportioning funds carefully. If one has a limited amount of money to spend on general testing for everything, looking at all possible illlnesses etc (like my whole country which has a finite budget for everything lol) then blowing one's whole budget on the NMR might not be the best use of those funds. And Im not convinced that the advanced lipids is the whole answer for those who have CVD with a normal basic lipid panel. Insulin resistance IMO plays a huge part and possibly drives some of the dislipidaemia and that can be ascertained by cheaper means. I believe the NMR is $100+ and might be even more expensive to access from a small town.

Looking from the outside, I am actually astounded on how many very expensive tests you guys living in the USA have done on your insurance for screening purposes. Its certainly not what would be happening in the UK or Australasia for instance, and probably much of Europe. Not a value judgement, just an observation.

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Stavia
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Re: what tests

Postby Stavia » Fri Jan 02, 2015 11:58 am

pgf54 wrote:Thanks Ski and hello Stavia, I hope I didn't cause offence with my whinge about Gp's, probably unkind of me as I know how so many people just want a quick fix or a pill and find lifestyle changes too hard. I wouldn't do your job for the world, but I do wish I had a Gp like you Stavia , it would be amazing................
Anyway , yes I meant fasting blood sugar by fbs and full blood picture by fbp...........I know psa is controversial but my Dad has prostate cancer and I have rs6983267 GG in addition which increases my odds 1.6% or so promethease tells me.
I will get the suggested tests and see how it goes, but maybe later at the end of the month as I did eat a bit extra over the festive season. I do have a history of fatty liver, and metabolic syndrome, though have lost a considerable amount of weight since then. Thanks for the suggestions Paul


Lol no offence taken honey, there are some crappy GPs and some burnt out exhausted ones.
Give yourself six weeks to reverse the festive overeating. And possibly alcohol. LFTs are a great surrogate marker for central obesity, so you need to lose enough weight to normalise them. Theyre a cheap indicator and your GP will be comfortable following them serially as its a tangible thing he/she can follow and bill your insurance for, and you can sneak in hba1c and lipids when rechecking the LFTs.
I hear you re the PSA. A once off is useless though, if you want screening yiu need serial measurements. But like I said its a can of worms for many many reasons.

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Ski
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Re: what tests

Postby Ski » Fri Jan 02, 2015 12:46 pm

Stavia wrote: If one has a limited amount of money to spend on general testing for everything, looking at all possible illlnesses etc (like my whole country which has a finite budget for everything lol) then blowing one's whole budget on the NMR might not be the best use of those funds.
Good point.

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Re: what tests

Postby Priv8Man » Thu Jan 08, 2015 4:21 pm

Hello Everyone! I've been lurking around here for a long while collecting information. Someday when I have more free time I will attempt a formal introduction. For now, I wanted to get some baseline labs. I found out that my insurance company will cover 100% as long as the lab is contracted. It appears that Quest Diagnostics is contracted so I was trying to come up with a list of labs to start with. Here's what I have so far (there may be some redundancy):

Lipid Panel
Apolipoprotein B (apoB)
Lp(a)
Lp-PLA2
Ion Mobility (NMR)
Homocysteine
hsCRP
Fibrinogen
Insulin
NT-proBNP
Vitamin D
Omega-3 and -6 Fatty Acids, Plasma
Hemoglobin A1c
B12
LFT (Liver Function Test)
TFT (Thyroid Function Test)
ferritin
testosterone
Lithium
CBC
Electrolytes

Please feel free to add to the list and/or offer suggestions or comments. BTW, just for a little background, I am E4/E4 with 2 parents with Alzheimers. The majority of my male relatives died of cardiovascular disease (CVD) prior to getting dementia. My female relatives had dementia and/or CVD. My father was one of my only male relatives to have both.

Thanks in advance,
Priv8

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Re: what tests

Postby Juliegee » Thu Jan 08, 2015 7:48 pm

Welcome Priv8! Wow- you've got a really comprehensive list of tests there. I searched out a few older threads that may give you some additional ideas.

Biomarkers to Track
https://www.apoe4.info/forums/viewtopic. ... kers#p1914

Suggested Tests for E4s
viewtopic.php?f=4&t=144

Check out the Therapeutic System 1.0 in Dr. Bredesen's recent paper. It may also point you towards some important biomarkers to track:
Reversal of cognitive decline: A novel therapeutic program http://www.impactaging.com/papers/v6/n9 ... 00690.html

Given your homozygote status (me too!) and strong family history, you may want to consider participating in Dr. Bredesen's Study. Please see the gold box at the top of the forum to learn more about this opportunity.


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