What blood tests to get?

(BuckRimfire) #1

I’ve been low-carb since the end of June. I had a lipid panel a couple of months in, which showed the predictable: HDL and total chol. up a little, triglycerides down, so that’s fine.

I have a medical check-up in a few days. Gonna get my every-six-months lead and ferritin, and another lipid panel. I’ve been eating a lot of canned pink salmon, so I’m going to ask about a mercury test, although pinks eat the lowest on the food chain of all the salmon species, so I hope they are fairly clean.

Probably also ask for a C-reactive protein just out of curiosity, and a “calcium score” (I believe that’s an MRI, not a blood test, per se) to see how the arteries are doing.

I don’t have signs of metabolic syndrome (BMI = 20 for decades on a careless diet, blood pressure was fine even before going low-carb) so I don’t know if there’s any point in getting an insulin or blood glucose, but I am open to suggestions. Any other tests you find interesting, and why?

(squirrel-kissing paper tamer) #2

If I could get any tests I wanted I’d go for

A1C (to recheck it or as a baseline)
Vitamin D and B12 (to see if supplementing is having an effect or if there is a deficiency)
Metabolic Panel (Chem) (to look at electrolytes)

(You've tried everything else; why not try bacon?) #3

HbA1C is a marker measure of glycation of your hemoglobin; it’s always good to know. Fasting insulin and glucose, I don’t see the point, really. Now, if the doctor wanted to order an oral glucose tolerance test—and if you wanted to sit around a lab for a couple of hours—that might tell you something. If you have any reason to suspect that your physician might be alarmed by your LDL, you could ask for an NMR analysis. Liver enzymes always make a doctor feel he’s keeping tabs on things, and of course you want your CBC (complete blood count)—I’m not sure why, but you do. (I can’t imagine your doctor not ordering it, in any case.) :smiley:

A coronary artery calcium scan (CAC) would be cool, if you’re made of money—I understand most insurance companies won’t pay for it, because it’s the one real assessment of actual heart disease. (Cynical? Who, me?) :grin:

(BuckRimfire) #4

I wish we’d gotten A1C tests before going on the diet, or in the first week. Even though I’m not the strictest eater, I’d be shocked and stunned if mine was much over 5, since I have no outward signs of diabetic tendencies. OTOH, my wife’s family is riddled with diabetes (her dad had three siblings and while he “only” had foot numbness and poor vision, I think a couple of them fared worse). We’re mostly on this diet for her sake. I’d have been very interested to see her A1C before and after the diet. Probably not going to go off it for three months just to get that number!

I’m switching docs because my old guy is semi-retiring and it’s time to start breaking in someone new. My wife went to this doc last fall and she was happy with her blood tests, even though she (the doc) knew she (my spousal critter) was on a high-fat diet, so I’m hopeful she won’t be scared of my results either. After a couple of months on keto, my total cholesterol was up a little at 235, but my HDL was 68 and my trigs were 56, so if that low trig/HDL ratio doesn’t reassure her, I should probably find a different doc, since I’ve been brainwashed to believe that is the most reliable of the
blood lipid markers.

Yes, I think the CAC was the test I was thinking of. Maybe I should call my insurer and ask if they will cover it.

(BuckRimfire) #5

I was also planning to ask for an ApoB, but I forgot about that temporarily! I’d better make a “note to self” to bring to my appointment.

(You've tried everything else; why not try bacon?) #6

Sounds as though you’re definitely on the right track. Keep us posted of the results, I’d be fascinated to see them. :bacon::bacon:

(BuckRimfire) #7

Got some results, with which I’m quite happy:

Metabolic panel and blood counts were all right down the middle of the ranges.

Iron measures were good, which is nice since I was anemic a few years ago (diagnosis was that this was simply due to excessive blood donation: 3 or 4 times a year over about ten years, so I was told to stop donating and it has slowly gone back up, with my biggest increase in ferritin since I went low-carb!)

C-reactive protein (cardiac) was 0.2 mg/L, so I’m very happy with that!

She didn’t order ApoB or CAC yet. Since everything else looked pretty good, she’ll probably be no more inclined to add those now. I’ll ask again for them, though.

Blood lipids over time as a jpg. Nice that the LDL went down a little, not that I am much concerned with that variable, but it will keep my doctor happy. It’s back to what it was two years ago when I was on a more “prudent” diet (although I was never zealously low-fat.) Very glad that my trig/HDL ratio has gone even lower. I think that I can confidently laugh in the face of anyone who says my saturated fat consumption is dangerous!

(The highest old trig value was NON-fasting; others are fasting except maybe the 100 score…not sure about that one.)
LipidPanel.pdf (69.9 KB)

(You've tried everything else; why not try bacon?) #8

Great results. Personally, I wouldn’t care so much about the ApoB, but boy would I want those CAC results!