Lipid panel improvements mega-thread — need advice

Dr.SleepRoch said:

A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin…

I read this differently from Dr.SleepRoch, on substance rather than tone. I would drop the "get everything" instinct further than this thread does. Every extra test is another chance at a false positive, and incidental findings have their own cost in scans, biopsies and worry.

MASHdoc_SA said:

My prescriber ordered three tests and this board recommends about twenty, and I would like to know which of those two lists is right.

Shot day Wednesday report relevant to baseline bloodwork:

Week 25. Currently on 15mg. Down 31 lbs from starting weight of 243 lbs.

This week's observations: Mild fatigue day 1-2 post-injection, then fine.

Labs due next week — looking forward to seeing the metabolic panel. I'll post results in the Lab Results section when they come in.

amsterdam_pete said:

I would drop the "get everything" instinct further than this thread does.

Adding the part of the answer the thread has not reached. ApoB is the more informative number and it is cheap. LDL-C estimates cholesterol mass in atherogenic particles; ApoB counts the particles, and it is particle count that tracks risk — which is why the two can disagree and why the disagreement is the clinically interesting case. Triglycerides fall substantially with weight loss and improved insulin sensitivity, HDL moves modestly, and LDL-C often barely moves at all, which surprises people who expected everything to improve together.

Following on from PedsEndoPhilly — and this may be the naive question:

How often to repeat it, because quarterly seems to be the convention and I cannot find the reasoning?

Closing the loop on my own question.

Took the whole panel in rather than the one flagged line, and the conversation lasted two minutes instead of generating three more tests.