Blood work physical

(Richard M) #1

Tomorrow I’m having my yearly blood tested. Other than the normal stuff that is tested, what are some other test I should have since being on keto for 3 months? Is there enough information from the basic CBC, CMP and lipid panel?

(Bacon by any other name would taste just as great.) #2

You could ask for an NMR analysis of your LDL. Be sure to get the inflammation markers (WBC, HS-CRP, and ferritin, in particular), HbA1C and fasting insulin., and C-peptide. You might also ask for a CAC scan, but most doctors won’t prescribe it, and most insurance won’t pay for it, because it may show that you don’t need to take a statin.

(BuckRimfire) #3

ApoA? LPa? I’m not actually sure what to do with either of those values, but some people are interested in them.

HOMA IR, maybe? Is this really any more helpful than trig/HDL ratio? I don’t know.

CAC (coronary artery calcium) is good, if only to establish a baseline. Mine was non-zero but low (24) which was an unpleasant surprise but not too scary. Not free, as Paul said, but usually $100 to $200. Not too bad if you don’t do it more than every few years. I’m curious to re-test in a few years and see if my non-zero score is due to two years on LCHF or 53 years on high-carb.

Carotid intima-medial thickness ultrasound seems like it is similar to CAC in implication, but IDK if one or the other is better.

DEXA scan or other examination of your liver fat and visceral fat? If you have any concerns about metabolic health, knowing your liver fat status seems worthwhile.

From your basic lipid panel, definitely look at your trig/HDL ratio.

(Bacon by any other name would taste just as great.) #4

It’s not the absolute value, but the trend that is important. Rising scores indicate a higher cardiovascular risk, stable or decreasing scores indicate minimal risk.

(Bob M) #5

GGT, if they’ll give it to you. Insulin, from which you can calculate HOMA-IR, if you also have fasting blood sugar.

ApoB is the latest buzzword from lipidologists. ApoB/ApoA also is a “relevant” factor according to them. I’ve only had these taken together twice, so I have no record with them.

I have had ApoB taken quite a few times, though it’s only recently people began paying attention to this.

As for Lp(a), you can get that taken, but I have extremely high Lp(a) (as in, “Holy Crap! You’re about to die any moment!”), yet a zero score on a CAC scan. And, there’s really no way to lower it (though I have a theory a low PUFA, high saturated fat does this). So, you’d just be freaking yourself out for no good reason, if your Lp(a) is “high”.