Blood Testing

[windsurf]

Every couple of years, I have blood drawn and sent for fairly comprehensive testing through the Life Extension Foundation to which I subscribe. The price is a couple of hundreds bucks for complete chemistry, cbc, lipids, PSA, total and free testosterone, estradiol, C-reactive protein, homocystine, and glucose. My total testosterone was up a couple of hundred points to 777 on a lab interval of 241-827. Being 60 years old, I was quite pleased with this reading. I ascribe it to losing some belly fat, cutting refined carbs and sugar, the right kind of exercise and more sleep than I used to get in the former career. Lipids were 196 total cholesterol with HDL at 58 which is down a bit from the last time though the ratio still yields a < .5 risk level for CHD. One reading that was new was glomerular filtration rate, estimated. Rich, I am hoping you know how this estimate is made. My serum creatinine is 1.1 which is normal for me (I eat a lot of protein and lift fairly heavy weights) and, as I said, I am 60. The lab didn't have my weight. My estimate was <59 mL/min/1.73. the normal interval is 60-137. So, how is this "estimate" calculated is what I am wondering.

 

[Rich_by_the_Bay]

Windsurf,

A true creatinine clearance (surrogate for glomerular filtration rate) requires a 24 hour urine collection with simultaneous blood draw. Unless you had that, your result for GFR is an imprecise estimate. Alas, along with most of the other tests you had, it is of little or no benefit in a screening setting, not to mention cost and generation of worrisome false positive results and another round of tests "just to be sure." Of course, I realize some of these may have been done to address previous concerns or symptoms, in which case at least some might be appropriate for you.

Your primary care doctor should have all the necessary information to determine which of the abnormals are of concern and which are not. My guess is that the creatininine clearance (GFR) is of no significance, esp if you have no predisposing risks for kidney problems.

Hope that helps.

 

[windsurf]

Thank you, Rich.

 

[smileydog]

Rich,

Are there any of these routine diagnostic test that the 55+ folks should be insisting on for preventative measures?

 

[Rich_by_the_Bay]

Are there any of these routine diagnostic test that the 55+ folks should be insisting on for preventative measures?

Here's a great place to start. I hope you find it useful.

 

[REWahoo]

Rich,

Are there any of these routine diagnostic test that the 55+ folks should be insisting on for preventative measures?

Here's a great place to start. I hope you find it useful.

Smileydog, please watch your PM's. You will receive an invoice for a medical consult from Dr. Rich on Monday.

 

[Rich_by_the_Bay]

Smileydog, please watch your PM's. You will receive an invoice for a medical consult from Dr. Rich on Monday.

No problem.

With all the money I've made from being a moderator, I don't need to send a bill.

 

[Notmuchlonger]

No problem.

With all the money I've made from being a moderator, I don't need to send a bill.

Rumor is you all get vacations to Hawaii? But you have to attend a conference on annuities. I wont tell you where I heard that from...

 

[calmloki]

Rumor is you all get vacations to Hawaii? But you have to attend a conference on annuities. I wont tell you where I heard that from...

N***s is turning his rental into a timeshare and has branched into anuity sales? That can't be right!

 

[smileydog]

Thanks for the info! The check's in the mail...

 

[windsurf]

I revisited the significance of lipid profiles. While the lab reports typically provide the ratio of total cholesterol to hdl (mine was 196/58 = 3.37 yielding a relative risk for coronary heart disease of 1/2 of an average adult), I saw some studies that suggest a more important marker is the ratio of triglycerides to hdl (mine is 1.15). A ratio of 2 is fine, 4 is high and 6 is much too high. So ,while my total cholesterol of 198 may be considered, without looking at more, near to concerning for borderline cardiac risk, it is not. If my cholesterol was even 250 but my hdl was 75 and triglycerides in the 60's, which they are now, I would still not worry.

 

[Rich_by_the_Bay]

I revisited the significance of lipid profiles. While the lab reports typically provide the ratio of total cholesterol to hdl (mine was 196/58 = 3.37 yielding a relative risk of 1/2 of an average adult), I saw some studies that suggest a more important marker is the ration of triglycerides to hdl (mine is 1.15). A ratio of 2 is fine, 4 is high and 6 is much too high. So ,while my total cholesterol of 198 may be considered, without looking at more, near to concerning for borderline cardiac risk, it is not. If my cholesterol was even 250 but my hdl was 75 and triglycerides in the 60's, which they are now, I would still not worry.

Looking only at the non-HDL cholesterol (total - LDL) is as good a predictor as any of the other ratios, all of which are approximate. I wouldn't start splitting hairs - lots of people have one or another index a little off base, so you have to view them in context (as well as the non-cholesterol risks).

 

[windsurf]

Rich, would you list the non=cholesterol risks? I assume that high blood pressure, obesity and diabetes are up there. We hear a lot about "inflammation," and that confuses me a bit. There is the association between periodontal disease and cardiac events which but I also encounter assertions concerning the danger of inflammation in the context of diabetes.

 

[FIRE'd@51]

I saw some studies that suggest a more important marker is the ratio of triglycerides to hdl (mine is 1.15). A ratio of 2 is fine, 4 is high and 6 is much too high.

I'm not a medical person, but I have read that many endocrinologists believe that a ratio of triglycerides to HDL greater than 3 is an indicator of insulin resistance, which is a precursor to type II diabetes.

 

[Rich_by_the_Bay]

Rich, would you list the non=cholesterol risks? I assume that high blood pressure, obesity and diabetes are up there. We hear a lot about "inflammation," and that confuses me a bit. There is the association between periodontal disease and cardiac events which but I also encounter assertions concerning the danger of inflammation in the context of diabetes.

You got 'em. Add tobacco use, sedentary lifestyle, renal failure and a few others. The periodontal link is probably real, but the studies to date are not conclusive. Similar with other chronic inflammatory states, but no one is sure.

 

[harley]

That's bad news for me. I appear to be genetically predisposed to low HDL. I've never tested above 25, and I know my triglycerides are higher than 75. Almost every other condition I know of (high LDL, BP, blood sugar, etc) can be managed decently by lifestyle, supplements, or at least meds. But nothing I've ever heard of seems to make more than a small (10%) difference in HDL levels. If anybody knows any better, I'd appreciate the info.

 

[windsurf]

Don't give up on that, Harley. My HDL used to be moderate and it now tends to be at the top of normal or (usually) considerably above. My triglycerides have come down from above 120 to levels in the 50's. Several years ago, I made a conscious effort out of fear to avoid becoming a type II diabetic. You may know where I am headed with this. I cut way down on sugar and refined carbohydrates, try to control belly fat and take fish oil. I can't imagine why else I could have drastic improvement other than my abandonment of the standard American diet disaster.