Hormone panel changes — 6 month update

PurityPaulOR 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…

I read this differently from PurityPaulOR, 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.

The figures, for anyone assembling their own picture. 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.

Dr.ObesityLA said:

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

Coming at Dr.ObesityLA’s question from a different direction. 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.

That is the short version; the long version is somebody else's post.

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

What actually belongs on a baseline panel, as opposed to the enormous list that gets pasted around here?

Reporting back.

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