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ForumsLab Results & BiomarkersHas anyone dealt with my bloodwork is so much better - showing my doctor was worth it?

Has anyone dealt with my bloodwork is so much better - showing my doctor was worth it?

Dr.RaviCardio Mon, Oct 7, 2024 at 2:59 AM 10 replies 1,790 viewsPage 1 of 2
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Dr.RaviCardio
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Oct 7, 2024 at 2:59 AM#1

This is the version of the explanation I wish somebody had given me, written down before I forget what confused me. It is about the baseline and follow-up panel, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

The single most useful discipline is bringing the whole panel to a clinician rather than one flagged value. One out-of-range result in isolation generates anxiety and unnecessary tests; the same result next to the trend and the rest of the panel usually generates a shrug.

The condition it depends on

Reference ranges are laboratory-specific. Comparing your number to somebody else's range, or to a screenshot from another country, is how people convince themselves something is wrong.

The practical version

Post reference ranges alongside numbers when you share them. Units differ by country — glucose and lipids especially — and half the confusion in these threads is unit mismatch rather than disagreement.

What I am not sure about

What I am trying to establish is how often to repeat it, because quarterly seems to be the convention and I cannot find the reasoning. I would rather have one careful answer than five confident ones.

— Dr.RaviCardio · corrections welcome and will be edited into this post with credit
5 0pete_manc_UK, anna.melb_AU, mark_tokyo and 2 others
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kate.chem
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Oct 7, 2024 at 4:26 AM#2
Dr.RaviCardio said:
The single most useful discipline is bringing the whole panel to a clinician rather than one flagged value.

No disagreement with Dr.RaviCardio. One condition attached. Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c becomes informative again, since it reflects about three months of glycaemia. After the first year, and once doses are stable, annual is reasonable unless something specific is being followed.

Last edited: Oct 7, 2024 at 7:26 AM
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TrialTracker_MD
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Oct 7, 2024 at 5:53 AM#3
Dr.RaviCardio said:
The single most useful discipline is bringing the whole panel to a clinician rather than one flagged value.

This is where I part company with the consensus forming above. 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.

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NurseLeah_Nash
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Oct 7, 2024 at 7:20 AM#4

This one has a reasonably settled answer, so here it is. 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 and B12, and a full blood count. That set catches the things that change, the things that explain symptoms, and the things that alter the prescribing decision. Almost everything else on the long circulating lists is either invariant, uninterpretable without a specific question, or an incidental finding waiting to cause an unnecessary workup.

Last edited: Oct 7, 2024 at 8:20 AM
2 22Dr.KarenChen, Dr.NateNeph
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JenPlateau
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Oct 7, 2024 at 3:48 PM#5
kate.chem said:
Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c…

Adding a me-too, because a thread of one person's experience is not much use.

Last edited: Oct 7, 2024 at 9:48 PM
1 21sarah_nash92
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