What Blood Tests Should I Request
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FIT_Goat
Posts: 4,224 Member
Hey everyone,
At the insistence of concerned family, I am going to talk to my doctor and get a series of blood tests done. Actually, the first step will be getting a primary care doctor, but my workplace has recently contracted with a clinic to ensure we all have primary care physicians. I'm calling them today to get up an initial appointment. Who knows how long it will be before I am actually able to get in there and get the blood tests done.
Test I already know am going to be asking for:
* Total Cholesterol and HDL levels
* LDL particle size test (is that the right name for it)
* Vitamin D (my mom's primary concern for some reason)
* Liver enzyme test (my aunt is convinced I'm going to get a fatty liver)
Are there any others I should ask for? What other tests should I pay attention to? Which tests should I get to show that this diet isn't killing me?
As a note, I do not believe that this diet is harmful in anyway. I feel better than I have in years, and I am well past the honeymoon stage where almost any diet will make you feel better than you felt before. I am not the one who is concerned. It would be nice to have the numbers to put some of my family at ease. I really want the particle size test because I probably could have total cholesterol over 200. In the past I've had measurements from 156-203, most around 180. They tell you your total cholesterol when you donate blood here. I will assume this diet has raised my total cholesterol 20-30 points (being pessimistic... it doesn't have to have done that), and will push me just over 200. So, I want to know, and be able to show, whether or not this increase is in harmful cholesterol or not.
At the insistence of concerned family, I am going to talk to my doctor and get a series of blood tests done. Actually, the first step will be getting a primary care doctor, but my workplace has recently contracted with a clinic to ensure we all have primary care physicians. I'm calling them today to get up an initial appointment. Who knows how long it will be before I am actually able to get in there and get the blood tests done.
Test I already know am going to be asking for:
* Total Cholesterol and HDL levels
* LDL particle size test (is that the right name for it)
* Vitamin D (my mom's primary concern for some reason)
* Liver enzyme test (my aunt is convinced I'm going to get a fatty liver)
Are there any others I should ask for? What other tests should I pay attention to? Which tests should I get to show that this diet isn't killing me?
As a note, I do not believe that this diet is harmful in anyway. I feel better than I have in years, and I am well past the honeymoon stage where almost any diet will make you feel better than you felt before. I am not the one who is concerned. It would be nice to have the numbers to put some of my family at ease. I really want the particle size test because I probably could have total cholesterol over 200. In the past I've had measurements from 156-203, most around 180. They tell you your total cholesterol when you donate blood here. I will assume this diet has raised my total cholesterol 20-30 points (being pessimistic... it doesn't have to have done that), and will push me just over 200. So, I want to know, and be able to show, whether or not this increase is in harmful cholesterol or not.
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Replies
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I saved this info* to take to my next Dr's appt. Perhaps it's what you are looking for. Thyroid might be a good idea, since many keto/low carbers report problems.
I hope others chime in!
*Vertical Auto Profile (VAP) test. This test will analyze your LDL cholesterol and determine if it is made up of predominantly the small, dangerous particles or larger, more benign particles. It will also tell you how much Lp(a) is circulating in your blood. In addition, the VAP test breaks out your HDL cholesterol subtypes, letting you know if you have more of the HDL2 subtype, which is most beneficial.
Lipoprotein Particle Profile (LPP) test. The LPP test also breaks down cholesterol into fractions smaller than LDL and HDL and analyzes the particles comprising each of them, just like the VAP test. But I believe the LPP test has an advantage over the VAP test, because its methodology allows for more precise measurements and because it can also measure remnant lipoprotein (RLP), which is a more threatening type of cholesterol that isn’t singled out by most other cholesterol tests.0 -
Thyroid is a good one, too, but make sure to get free and reverse T3 and free T4 and not just the TSH number. (See also: http://www.stopthethyroidmadness.com/recommended-labwork/ for Thyroid related labwork - it also mentions iron, folate, B-12, magnesium, and other labs, which are also worthwhile.)
Insulin, A1C, and fasting glucose are good, too, especially if you're at risk for Diabetes. IMO, it's just good to know those numbers, anyway (and then watch them improve).
You could also throw in a testosterone/androgen test, especially if your particular diet version cuts out things like soy (and it can be interesting to see if the levels change, as a high fat diet is supposed to be hormone-balancing). This one's pretty low on the priority list, though.
Also, non-alcoholic fatty liver disease has been more closely linked to fructose consumption than fat consumption. So....yeah...0 -
Cholesterol VAP testing (Much better than some numbers)
Thyroid.
Fluids and Electrolytes: Includes Chloride, Potassium and Sodium.
Liver: Includes Albumin, Alkaline Phosphatase, Alanine Transaminase (ALT or SGPT), Aspartate Transaminase (AST or SGOT), Total Protein, LDH, Total Globulin, Albumin/Globulin Ratio, and GGT.
Kidney: Includes Blood Urea Nitrogen (BUN), Creatinine, BUN/Creatinine Ratio, eGFR, and Uric Acid.
Glucose
Mineral and Bone: Total Iron, Calcium, and Phosphorus.0 -
Awesome. Thanks. If anyone else can think of anything, let me know. I'm going to make a list of these and see what it's going to cost to get it all tested. My insurance should cover some of them. I may have to pay for some of the non-standard ones. I have a family member that may be able to get me a discount because she works in a lab. That could make it more affordable.0
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Alright, I talked to my family member that works at a blood lab. They were able to get me in today for free for just the Lipid Panel and Comprehensive Metabolic Panel. These aren't all the tests everyone mentioned. But, they will be a good base to bring when I do see my doctor. If there is something out of line on those, we can do further testing (the particle size and thyroid) ones.
I don't think I have an issue with my thyroid. I have calculated my own TDEE (from trend-lines and caloric intake) and it's about 2,650 calories. That would be what my BMR (by age, height, gender, and weight) x 1.58 (moderately active) says it should be. I don't think I am really moderately active, but I could be. I do walk a lot during the day (12k steps). Anyway, I definitely am not seeing a slowing of my metabolic rate at this time. So the odds of me having hypothyroid is low. After I talk to the doctor, I'll see if he wants to do those tests.
Once I get these results (should be tomorrow), and get an appointment with my doctor, I can look at the other tests. I really do want to get a complete workup done. I'm a bit of a numbers/data geek--if you couldn't tell from the fact that I calculated my actual TDEE from my own numbers and not a formula--and the more data I have the better I like it.
Tests I had drawn for this morning:
* Total Cholesterol
* HDL
* Chol/HDL LDL
* LDL/HDL
* Trigs
*Albumin
* Bilirubin
* BUN
* Calcium
* Chloride
* Creatine
* Glucose
* Phosphatase, Alkaline
* Potassium
* Protein, T
* Sodium
* AST (SGOT)
* Carbon Dioxide
* ALT, SGPT
So, it's not everything I want. But, it's a start.0 -
One of the comparisons I came across recently recommended that the number to pay attention was the ratio of triglycerides to HDL. I'll see if I can find who and where this was mentioned and add it to this conversation.0
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I saw that also. I think I ran across it on the site of the guy who ate almost 5,800 calories on various diets where he was talking about his blood tests. I think he said the ratio should be less than 2. I will see if I can find it.0
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The literature surrounding the ratio of Trig to HDL seems to be pretty solid. If you Google "triglycerides to HDL ratio" you'll find several links that seem to be pretty reputable, i.e., not SWAG. Here is a summary from one of the links I came across:
HDL is closely related to triglycerides.
It appears common for people with high triglycerides to have low HDL's, and these same people also tend to have high levels of clotting factors in their blood stream, which is unhealthy in protecting against heart disease.
Therefore, in adults, the triglyceride/HDL-"good" cholesterol ratio should be below 2 (just divide your triglycerides level by your HDL).
Or more precisely, the triglyceride/HDL ratio:
2 or less is considered ideal
4 - high
6 - much too high
And, since HDL (high density lipoprotein) is protective against heart disease, the lower the ratio, the better.
In other words, the lower your triglycerides, or the higher your HDL, the smaller this ratio becomes.
It is now believed that the triglycerides/HDL ratio is one of the most potent predictors of heart disease.
A Harvard-lead study author reported:
"High triglycerides alone increased the risk of heart attack nearly three-fold.
And people with the highest ratio of triglycerides to HDL -- the "good" cholesterol -- had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL in the study of 340 heart attack patients and 340 of their healthy, same age counterparts.
The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more accurate than the LDL/HDL ratio0 -
Thanks, that is good information to know--just in case my total cholesterol comes back high.
I honestly am not expecting any problems. I am just trying to allay some of the fears my family members have.0 -
I am a health professional and from that standpoint, the best person to evaluate your risks and determine what labs should be drawn is your Doctor. Many factors come into play, such as your age/weight/ and family history. It is often unnecessary to do extensive bloodwork to "diet". That being said, if you have any kidney issues, a low carb diet may effect your kidneys. If you are doing low carb or "Atkins" you may want to take some vitamin supplements as you have to replace what you are deficient in. Usually taking a Calcium and sometimes Potassium supplement is recommended and Omega 3's. Good luck!0
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I am still trying to get a doctor appt. They haven't gotten back to me, yet. A lipid panel and a metabolic panel seem to be standard for just about everyone. I'm planning on bringing it with me to the doctor. That way we'll have one more thing to consider before we talk about additional tests.
I take a daily multivitamin, magnesium, and use the salt with potassium to help keep my electrolytes balanced. I eat sardines at least once a week, for the omega-3s, and am generally trying to do this all correctly. I sometimes make some replacement foods using flax meal, which also has some omega-3s. I think I'm doing a pretty good job in that respect. Time will tell.
I haven't got the results back, yet. Should be tomorrow or Friday.0 -
Finally got my results. I am pretty pleased with the numbers. I would like to improve the trigs/HDL number (it's a 2.6... I was hoping it would be under 2.0. It still isn't that bad).
I got my step-mother to send me pictures of the results to my phone. I'm getting the actual paper copy later (so I am dealing with cut-off images). The long and short of it, everything is in the perfectly normal range. I am pretty excited. Now I have a baseline and I can tell people that this diet isn't silently killing me.
* Total Cholesterol: 168
* HDL: 53
* LDL (calc): 87
* VLDL (calc): 28
* Chol/HDL LDL: 3.17
* LDL/HDL: 1.64
* Trigs: 139
*Albumin: 4.4
* Bilirubin: 0.3
* BUN: 13
* Calcium: 8.9
* Chloride: 99
* Creatine: 0.98
* Glucose: 70
* Phosphatase, Alkaline: 105
* Potassium: 4.3
* Protein, T: 7.4
* Sodium: 139
* AST (SGOT): 24
* Carbon Dioxide: {NOT IN THE IMAGES SENT}
* ALT, SGPT: 38
Anyway, there you go. I'm going to take these numbers with me when I go talk to my doctor (still waiting for them to call me back, which is insane). I'll probably see if I can get further testing done, as recommended above.0 -
Great job! Sounds like you are spot on and have nothing to worry about!! Or your family for that matter!
Keep up the great work!0 -
Well, I'm not a M.D., but I'd say your numbers look really good. Glucose at 70 is great. Trig/HDL seems to be quite good. Total cholesterol (assuming you are not on a statin) also looks good (although I don't pay much attention to that myself I know some folks think it is pretty important).0
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Nope. No statins here. I'm pretty pleased with these numbers. When I do talk to a doctor, I am bringing these numbers and my food log. I'm going to talk to him about where I am at and see what he wants to watch and how often he wants to watch it. I don't think there's anything to be concerned about, but it has made my family a lot less worried about me (to get these numbers). Being able to say I am under a doctor's supervision, while continuing, will ease their minds even more.0
