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Vegan - Physical/Blood Tests

jm_1234jm_1234 Posts: 142Member Member Posts: 142Member Member
I'm about to schedule my annual physical and blood work and am curious what tests are recommended for vegans.

I've been vegetarian for a few weeks (only animal product is whey protein) and once the whey is gone I will be vegan. My goal with the tests is to establish a baseline for future comparison and to keep an eye on areas that veganism can complicate. If it matters, I live in the US, have insurance, and am fine with out of pocket costs.

From my research I found the below recommended. Am I missing anything? Or is this overdoing it?

Calcium
CBC – Complete Blood Count - With Differential and Platelets
CMP – Comprehensive Chemistry/Metabolic Panel
Folate, Folic Acid
Hemoglobin A1C
Homocysteine
HS-CRP (high-sensitivity C-reactive protein)
Iodine
Iron - Ferritin, Total, and TIBC
Lipid Panel
MMA – Methylmalonic Acid, Serum
Omega-3 Index
Selenium
TSH: Thyroid Stimulating Hormone
Urinary Iodine
Vitamin B12
Vitamin D - 25 Hydroxy (Vitamin D-3)
Vitamin K2
Zinc
edited January 23
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Replies

  • BecomingBaneBecomingBane Posts: 3,667Member Member Posts: 3,667Member Member
    Blood tests aren't really recommended unless you are looking at something specific or for a specific reason.

    That said, I do the most comprehensive blood tests I can convince my doctor to run every year or so because I like to see the data trends on my n=1 experiments.

    Just talk to your doctor and tell them what you want and why. Blood tests can get expensive as I generally pay several hundred dollars each year to have this done, after my insurance covers the rest.
  • bold_rabbitbold_rabbit Posts: 687Member Member Posts: 687Member Member
    Many of those are covered by the standard blood tests. Do you have (or can you get) a copy from last year? You can see which ones you had then.

    Our doctor also runs D and B-12.

    And TSH, but I think it's because we are older.
  • janejellyrolljanejellyroll Posts: 21,530Member Member Posts: 21,530Member Member
    To me personally, this sounds like an awful lot of testing. I've been vegan for about thirteen years. For the past few years, I've had iron, vitamin D, and B12 tested during my annual physical. Insurance covers this (the vitamin D I think is covered for everyone, but other two are specifically covered due to my "diagnosis" of veganism). I wouldn't add more tests unless I had a specific condition or my doctor recommended it.

    Now if you like data, this may be worth it. But getting it done just because you're vegan -- I wouldn't worry about it.
  • cwolfman13cwolfman13 Posts: 37,599Member Member Posts: 37,599Member Member
    When I get my annual physical, my Dr. sends me for a comprehensive metabolic panel as that is what most insurance will cover for an annual physical. It includes most of what you've listed. From there, if anything looks unusual the Dr. can send for further and more detailed testing on a potential matter of concern. A comprehensive metabolic panel is going to, at minimum, be able to provide a Dr. with enough information to determine if there's anything unusual going on that should be tested and investigated further.
  • jm_1234jm_1234 Posts: 142Member Member Posts: 142Member Member
    Thanks. This will be my first physical and blood work - I'm 37 and no health issues so far.
  • bold_rabbitbold_rabbit Posts: 687Member Member Posts: 687Member Member
    jm_1234 wrote: »
    Thanks. This will be my first physical and blood work - I'm 37 and no health issues so far.

    Just ask your doctor to run standard fasting blood work, which will cover nearly everything you listed. You will need to fast overnight (I'm not sure about the number of hours because I don't eat after 7). You can have water, and usually the test goes better if you do. (I will likely get disagrees on this, but I have verified that this is correct.). Most likely they will also order a urinalysis.

    You can also mention that you are vegan and would like D and B-12 checked. You can also ask for TSH if you desire.

    I like to get the blood work done about a week before the physical so we can discuss results. I also ask the nurse for a copy before the doctor comes in.

    Be aware that values can fall outside of normal ranges without it being a reason for concern. For example, my triglycerides are usually under the "normal" range, but that does not mean I have a problem. I just naturally have low triglycerides.
  • apullumapullum Posts: 4,896Member Member Posts: 4,896Member Member
    If you’ve been vegetarian for a few weeks, that’s not really enough time to see changes in most of those tests that could be caused by your dietary changes. For example, your liver stores about 3-5 years worth of B12, so if you are not already deficient in it, then it would take several years to develop a deficiency assuming you weren’t supplementing properly.
  • lynn_glenmontlynn_glenmont Posts: 7,554Member Member Posts: 7,554Member Member
    To me personally, this sounds like an awful lot of testing. I've been vegan for about thirteen years. For the past few years, I've had iron, vitamin D, and B12 tested during my annual physical. Insurance covers this (the vitamin D I think is covered for everyone, but other two are specifically covered due to my "diagnosis" of veganism). I wouldn't add more tests unless I had a specific condition or my doctor recommended it.

    Now if you like data, this may be worth it. But getting it done just because you're vegan -- I wouldn't worry about it.

    I've never been "diagnosed" as a vegan, and my insurance-covered annual physical blood tests have always included checking vitamin D and iron. I'm not sure about whether B12 is covered. I don't recall seeing it, but it's possible it's there and I just didn't notice because I was in the normal range.
  • lynn_glenmontlynn_glenmont Posts: 7,554Member Member Posts: 7,554Member Member
    apullum wrote: »
    If you’ve been vegetarian for a few weeks, that’s not really enough time to see changes in most of those tests that could be caused by your dietary changes. For example, your liver stores about 3-5 years worth of B12, so if you are not already deficient in it, then it would take several years to develop a deficiency assuming you weren’t supplementing properly.

    OP said they want the test now for a baseline -- i.e., they want to know what things are like before the effects of veganism kick in.
  • janejellyrolljanejellyroll Posts: 21,530Member Member Posts: 21,530Member Member
    To me personally, this sounds like an awful lot of testing. I've been vegan for about thirteen years. For the past few years, I've had iron, vitamin D, and B12 tested during my annual physical. Insurance covers this (the vitamin D I think is covered for everyone, but other two are specifically covered due to my "diagnosis" of veganism). I wouldn't add more tests unless I had a specific condition or my doctor recommended it.

    Now if you like data, this may be worth it. But getting it done just because you're vegan -- I wouldn't worry about it.

    I've never been "diagnosed" as a vegan, and my insurance-covered annual physical blood tests have always included checking vitamin D and iron. I'm not sure about whether B12 is covered. I don't recall seeing it, but it's possible it's there and I just didn't notice because I was in the normal range.

    That's good to know -- my doctor may be misinformed or my insurance may be weird, she just told me that the "diagnosis" would make sure I was never charged for the tests.
  • lemurcat2lemurcat2 Posts: 4,503Member Member Posts: 4,503Member Member
    Lots of insurance policies require a diagnosis for certain tests or treatments. When I was seeing a therapist some years ago I was told they needed to assign a diagnosis for the insurance to cover the sessions.
  • lynn_glenmontlynn_glenmont Posts: 7,554Member Member Posts: 7,554Member Member
    lemurcat2 wrote: »
    Lots of insurance policies require a diagnosis for certain tests or treatments. When I was seeing a therapist some years ago I was told they needed to assign a diagnosis for the insurance to cover the sessions.

    Apparently insurance companies don't know what diagnosis means. A patient presents with symptoms. The doctors orders tests in order to determine a diagnosis. If they already had a diagnosis, they wouldn't (generally) need a test, unless it's for checking blood levels of a drug prescribed for treatment, or something like that. Oh, I see -- it's an insurance company catch-22. You can't get a diagnosis without a test, but you can't get a test without a diagnosis.
  • lemurcat2lemurcat2 Posts: 4,503Member Member Posts: 4,503Member Member
    lemurcat2 wrote: »
    Lots of insurance policies require a diagnosis for certain tests or treatments. When I was seeing a therapist some years ago I was told they needed to assign a diagnosis for the insurance to cover the sessions.

    Apparently insurance companies don't know what diagnosis means. A patient presents with symptoms. The doctors orders tests in order to determine a diagnosis. If they already had a diagnosis, they wouldn't (generally) need a test, unless it's for checking blood levels of a drug prescribed for treatment, or something like that. Oh, I see -- it's an insurance company catch-22. You can't get a diagnosis without a test, but you can't get a test without a diagnosis.

    I suspect it's more that they need a reason to order tests they wouldn't normally. For example, my mom had hemochromatosis, so my sister and I have a reason (even in the absence of symptoms) to get our iron levels checked and that was covered.

    Diagnosis is probably the wrong word and Jane's doctor may have used it casually when another would be better, but I wouldn't be surprised if knowing a patient is vegan fits the criteria for covering tests that would not normally be ordered (arguably so would knowing a patient has been dieting or lots of different things).

    I know when I was obese I got tested for markers of T2D and when thinner did not always. Someone diagnosed with T2D will certainly get tests that are not routinely covered in many cases.

    People over a certain age will have various tests covered that are not for younger people.
    edited January 24
  • cwolfman13cwolfman13 Posts: 37,599Member Member Posts: 37,599Member Member
    lemurcat2 wrote: »
    Lots of insurance policies require a diagnosis for certain tests or treatments. When I was seeing a therapist some years ago I was told they needed to assign a diagnosis for the insurance to cover the sessions.

    Apparently insurance companies don't know what diagnosis means. A patient presents with symptoms. The doctors orders tests in order to determine a diagnosis. If they already had a diagnosis, they wouldn't (generally) need a test, unless it's for checking blood levels of a drug prescribed for treatment, or something like that. Oh, I see -- it's an insurance company catch-22. You can't get a diagnosis without a test, but you can't get a test without a diagnosis.

    I think maybe diagnosis is the wrong word. The way my Dr. described it to me was that my insurance would cover a comprehensive metabolic panel as part of my annual physical since my insurance covers preventative medicine. Insurance wouldn't however cover an A1C test without a comprehensive metabolic panel coming back showing above normal blood glucose numbers.

    When my triglycerides and cholesterol were through the roof as evidenced by my metabolic panel my Dr. was able to order quarterly lipid panels to be performed and insurance would pay for it since I was diagnosed with high cholesterol.

    In the case of being "diagnosed" vegan I could see that being put in one's file to cover blood tests that wouldn't otherwise be covered because Dr.s have to have some documented reason to send people for certain treatments and have insurance cover it, otherwise it comes out of pocket.
  • janejellyrolljanejellyroll Posts: 21,530Member Member Posts: 21,530Member Member
    lemurcat2 wrote: »
    lemurcat2 wrote: »
    Lots of insurance policies require a diagnosis for certain tests or treatments. When I was seeing a therapist some years ago I was told they needed to assign a diagnosis for the insurance to cover the sessions.

    Apparently insurance companies don't know what diagnosis means. A patient presents with symptoms. The doctors orders tests in order to determine a diagnosis. If they already had a diagnosis, they wouldn't (generally) need a test, unless it's for checking blood levels of a drug prescribed for treatment, or something like that. Oh, I see -- it's an insurance company catch-22. You can't get a diagnosis without a test, but you can't get a test without a diagnosis.

    I suspect it's more that they need a reason to order tests they wouldn't normally. For example, my mom had hemochromatosis, so my sister and I have a reason (even in the absence of symptoms) to get our iron levels checked and that was covered.

    Diagnosis is probably the wrong word and Jane's doctor may have used it casually when another would be better, but I wouldn't be surprised if knowing a patient is vegan fits the criteria for covering tests that would not normally be ordered (arguably so would knowing a patient has been dieting or lots of different things).

    I know when I was obese I got tested for markers of T2D and when thinner did not always. Someone diagnosed with T2D will certainly get tests that are not routinely covered in many cases.

    People over a certain age will have various tests covered that are not for younger people.

    Yeah, I don't think my doctor meant "diagnosis" in the absolute clinical correct sense of the term. I think she used it as an off-hand way to explain why it was relevant that she including my veganism in the written orders for the test. If it makes more sense, we can say "officially noting a circumstance or lifestyle condition that explains why a particular test may provide medically relevant information" instead of "diagnosis."

    It's just like if you're a smoker, your doctor may want different tests for you. Are you "diagnosed" as a smoker? No, not really, but it's a term that may make sense to laypeople (which is what I am!).
  • nooshi713nooshi713 Posts: 3,926Member Member Posts: 3,926Member Member
    That list is a bit overkill. What you should have tested depends on age.

    Standard physical includes CBC, CMP, TSH, cholesterol. Nowadays many people are vitamin D deficient so if you have fatigue at all, it is worth throwing in that one.

    Vegan specific labs, add B12 level.

  • earlnabbyearlnabby Posts: 7,765Member Member Posts: 7,765Member Member
    My PCP's Medical Group calls them "Known Medical Concerns" as opposed to a term like diagnosis. This is a catch-all for things like an actual diagnosis like T2Dm, hypertension, A-fib, etc.; lifestyle things like excess weight, alcohol use, smoking, etc.; and age related things like menopause. They can be diagnosed or self reported. Getting it in the record as official gives the doctor direction for what tests to order and how often to order them plus coordinates with insurance.
  • oedipussoedipuss Posts: 50Member Member Posts: 50Member Member
    If you are tested for B12 make sure it is for Active B12 not Total B12.

    Total B12 is bound to a glycoprotein called haptocorrin. However, B12 bound to haptocorrin cannot be used by the vast majority of the cells of the body. Only B12 bound to transcobalamin (Active-B12), which is a transport carrier protein, is taken up from the blood into the cells of the body.
  • jm_1234jm_1234 Posts: 142Member Member Posts: 142Member Member
    Thanks! A quick update..I've been PBWF with the exception of whey protein since 1-1-20 and all was good except the below. Any recommendations for the below?

    I'm guessing the LDL problem might be due to a dirty bulk pre-PBWF, the holidays, and lack of cardio due to an ankle injury - but not really sure. Garmin estimates my BF is 11.4% as of this morning.
    • Ferritin is on the high end at 411 (I blame my love for beans and hummus)
    • D is low at 15
    • B12 is on the low end at 280
    • LDL is on the high end at 114
    edited February 14
  • janejellyrolljanejellyroll Posts: 21,530Member Member Posts: 21,530Member Member
    jm_1234 wrote: »
    Thanks! A quick update..I've been PBWF with the exception of whey protein since 1-1-20 and all was good except the below. Any recommendations for the below?

    I'm guessing the LDL problem might be due to a dirty bulk pre-PBWF, the holidays, and lack of cardio due to an ankle injury - but not really sure. Garmin estimates my BF is 11.4% as of this morning.
    • Iron is on the high end at 411 (I blame my love for beans and hummus)
    • D is low at 15
    • B12 is on the low end at 280
    • LDL is on the high end at 114

    Is your doctor concerned about any of these? My understanding is that "high end" and "low end" are not issues as long as they're within the acceptable range. I personally wouldn't take any action in response to "high end" iron unless my doctor recommended it.

    Are you currently supplementing D and B12? If not, that would be my best suggestion to address those. There are no known downsides, to my knowledge, to supplementing either of those (of course, your doctor would be the final authority).

    I am not sure what "dirty bulk" means exactly in your situation, but if you feel your diet is the cause of your high end LDL, less than two months of a changed diet probably isn't enough to totally address it. I think most people wouldn't see a big change in lab values with a couple of months. But I'm not sure what your LDL was before or if it was a concern for your doctor.
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