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Which blood tests should I ask for in order to best evaluate my health/find potential issues? 24yo

Answered on February 05, 2015
Created July 16, 2013 at 9:17 AM

Hi all,

I would like some suggestions on what blood tests to take. Here are some facts

  • Strictly Paleo diet with < 100g carbs a day, plenty of greens
  • BT showed low serum B12 (104/637 pmol/L) 1 year ago
  • BT showed low Ferritin 1 year ago
  • Pernicious anaemia tests negative
  • Suffer from Acne which I am attempting to resolve with diet/detox/supplementation

A few months before getting the low B12 test I stupidly mega-dosed B5 in an attempt to get rid of my acne. I was taking 5-10g daily doses for about a month before I things started to become funny at which point I stopped. I suspect that this mega-dosing is what caused the B12 and Ferritin deficiency.

For about 5-6 months I administered oral methylcobalamin 5mg + 3mg dibenconzide. I also self administered 8 shots of Cyanocobalamin into fat and I had 1 IM administratom Hydroxocobalamin by a practitioner. After all this my B12 level was close to 1000 in January.

I continued to take the oral B12 forms on a less frequent basis for the next few months but stopped due to a suspected potassium deficiency (muscle twitches) but mainly because I wanted to get another test done at a time I was no longer supplementing. It has been about a month since I have stopped B12 supplements. Also, I will admit that the Feritin problem has been overlooked completely somehow. I just remembered that I had low Feritin now that I found the paperwork, and the physician didn't seem to mind so no supplements were taken for it.

I'd like to know which blood tests to take to get an accurate representation of my B12 level, as well as my overall health considering my diet. Anything else you guys suggest I test in relation to my B12/Ferritin problem (not sure what's happening with the Ferritin/B12 now but I'm very keen to find out). Any good things tests to have for my acne problem? Is there a better B12 test I can take?

The physician suggested I get an endoscopy to find out if there is something wrong with my gut but I suspect all this mayhem is linked to the B5 adventure so I'm hoping everything will be OK now. I generally feel fine, heaps of energy, brain works fine.

Edit: I forgot to mention that I also had low Vit D (56/140) nmol/L which is mostly genetic. I have sorted it out with 5000IU ED supplementation. I'm 24 years of age.

Thanks!

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 10:41 PM

Thank you elf27, your advice is greatly appreciated. I will do this.

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 10:36 PM

Sgracent - thank you, your advice is greatly appreciated.

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 09:55 PM

I'm from Australia. Ferritin level was 31ug/L (30-300 range). Vitamin D waas 47nmol/L (51-140 range). Haemoglobin and Hematocrit were both perfectly fine. I'm not taking any supplements any more, I had D re-checked and it was fine after the 5000IU supplementation. Vitamin B12 was also now high since I also supplemented with that. It's been a while since I stopped taking supplements (Just CLO and 15mg Zinc now) so I can't wait to see how everything is looking.

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 09:40 PM

Sorry for scolding you Matt, I no longer hold resentment towards you and I am happy that you took the time to post in my thread.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on July 17, 2013
at 12:16 PM

DopeFiend, most people who post answers are really trying to help. Yet in fact many answers are not helpful, unfortunately. I think it is proper (and appropriate) etiquette to thank people for their time and consideration rather than to scold them.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 17, 2013
at 12:12 PM

Hope he's insured, that's a lot of tests! But probably the ones he should be doing. Also, good on recommending no supplements til things are figured out.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 17, 2013
at 11:51 AM

Matt, based on the evidence, all we can say is that excessive supplementation does not help figure out how to post a comment.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 17, 2013
at 11:19 AM

What do you expect? You left out a lot of detail except for excessive and capricious supplementation. I simply pointed out that you can't figure anything out supplementing like that.

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 08:12 AM

Did you even read or comprehend anything I wrote? Please see my reply 'Answer'. And don't post in my thread again :@

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6 Answers

5
32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 16, 2013
at 01:25 PM

Holy excessive supplementation, Batman! Put down the pills, and eat some real food. Like another question this morning, you don't have a proper baseline from which to hack, you're entire diet/supplementation scheme is random, disjointed and unorganized. You can't possibly tell what supplement is having what effect.

I wouldn't expect B5 to muck up Fe or B12 either.

Be a scientist, change one variable at a time to see what effect it has. The shotgun approach to supplementation is a recipe for an empty wallet.

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 08:12 AM

Did you even read or comprehend anything I wrote? Please see my reply 'Answer'. And don't post in my thread again :@

3
157ef302455b7accd9ccf519207e09eb

on July 17, 2013
at 11:19 AM

Hey There,

I am new to paleo but I'm a last semester nursing student and I've worked for a GI doc for the last 6 years. You need to repeat the B-12 lab and you also need to get an Iron panel. Your Ferritin could have been low from the B-12 deficiency. I would also recommend having your Vitamin D checked. B-12 is water soluble meaning and excess will be eliminated in your urine. Vitamin D in the other hand is fat soluble and can be toxic if you get too much. 5000IU is a big dose and that level needs to be checked. When you get your labs back if your Ferritin is still low but your B-12 is normal then you probably should have an EGD w a small bowel bx to rule out Celiac disease, Crohns, or some other type of inflammatory process. People with normal bowels (ie no resection or chronic disease) who eat a good diet (whole foods etc) do not normally need B-12 injections. I personally would ask for CBC, Chem 12, Iron panel/profile, B-12, and Vitamin D based on the information you supplied. I know you stated you have stopped the supplements and I would stay off of them unless instructed by your MD to go back on them. I hope I have provided some help :-)

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 10:36 PM

Sgracent - thank you, your advice is greatly appreciated.

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 17, 2013
at 12:12 PM

Hope he's insured, that's a lot of tests! But probably the ones he should be doing. Also, good on recommending no supplements til things are figured out.

1
8d3cb0be5f31c75a05f853cb3b5c245a

(1601)

on July 17, 2013
at 08:20 PM

http://chriskresser.com/b12-deficiency-a-silent-epidemic-with-serious-consequences

He says the B12 lab from this company is sufficient:

https://directlabs.com/Default.aspx

Then he published this: http://chriskresser.com/what-everyone-especially-vegetarians-should-know-about-b12-deficiency

"Some experts believe that urinary MMA is superior to serum MMA as a marker ??? possibly because it is more concentrated in the urine than the blood. However, elevations in urinary MMA can also be caused by kidney dysfunction. (5, 6) On the other hand, serum MMA can be elevated in the presence of intestinal bacterial overgrowth. (7). Therefore, which test you choose should depend on your health status. If there???s any question of impaired kidney function, serum MMA would be a better choice. If you have or think you may have SIBO or gut dysbiosis, urinary MMA would be the better choice. Quest, Labcorp and many other labs offer both serum or urniary MMA, so you shouldn???t have any problem getting it provided your doctor will order it. Note that you need to be fasting for the urinary MMA to get an accurate result."

So urinary MMA for Quest, Labcorp is another option for b12. But the serum B12 should be ok.

Also, be aware that you can have a high serum value (direct labs test) and still be deficient. Kresser addresses this in his article.

As for other blood tests, might I suggest involving a doctor to work with you on the Organix urinary profile (or some other urinary test) which shows which vitamins and minerals you have deficiencies in, despite your supplementation?

Also consider working with a doctor to find the cause of your low ferritin and B12. Kresser says that many of his clients who eat meat 2-3 times per day still have low B12 and must supplement, but rather than supplementing as you are, I think you need to realize that supplementation can cause as much harm as good.

I feel your pain! Acne is terrible. But you want to get everything - vitamins, minerals, calories, greens even- in a good, healthy range, and not be too high or low in any one nutrient or mineral. Get everything in balance. and rejoice because at least you feel good, mentally, and sleep well and have got your diet pretty dialed in.

A doctor can help you get the last 10% out of the way - addressing mineral deficiencies, which should help acne. If it doesn't, consider seeing a functional MD to consider stool testing for the presence of pathogens, or to show if there is an imbalance of gut bacteria, etc.

SEE A DOCTOR. You will drive yourself crazy trying to fix this on your own. Take it from me.

Hi DopeFiend - I forgot to add, I didn't know you were taking other supplements like CLO and 15 mg of zinc per day. I would really, really recommend perfect health diet supplementation and diet. The alternative is to design a diet and track, via Fitday, all your foods to be sure you're meeting your recommended RDA's. But that seems like too much work and stressing, and it seems like you're already pretty stressed out.

It's possible the CLO is affecting your gut, as well as the zinc. By supplementing like you are it's possible that you are throwing your minerals out of balance. There are things called biofilms which can form and protect bad bacteria. Perhaps it's a little fear-mongering, but the fact is, bacteria and fungi and parasites have been a natural good and bad presence in our bodies. (Yes, even parasites - there is even one which can make phosphatidylserine, a compound important for the production of neurotransmitters)

When you provide too many vitamins or minerals and throw the balance off, it lets, say some bad bacteria perhaps overtake good bacteria.

Try to work with a doctor! Believe me, I know - supplements are a good way to spend money and a bad way to see results. Work with a doctor!

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 10:41 PM

Thank you elf27, your advice is greatly appreciated. I will do this.

0
E7ddc4fb9f0287e2a45b55e83d00c0c2

on February 05, 2015
at 12:20 PM

Typically blood tests are performed to determine any underlying causes or conditions which are affecting your health. It provides a wealth of information about identifying the root of diseases. The most common type of blood tests performed in pathology through the equipments available at ilexmedical website are:  
 

A complete blood count (CBC): It helps in detecting blood diseases such as blood cancers, infections, anemia, clotting problems etc.
 

Blood chemistry tests: It helps in measuring the different chemicals in the blood.
  

Blood enzyme tests: Enzymes are usually a chemical that helps in controlling chemical reactions in our body; this test is basically performed to check for heart attack.
   

Blood tests to evaluate heart disease risk: This test usually looks substances which can be a cause of heart diseases.

Blood Clotting Tests: It is also called coagulation that checks protein level which becomes the cause of clotting in your blood.

0
Ef2201fca868cf41c70bf3c1bf29728c

on July 17, 2013
at 01:50 PM

DopeFiend,

I forgot to answer you question about the lab. Serum B-12 is what our office normally runs. There may be more specialized labs but for your current purposes that one will work. Do you know what your initial low Ferritin level was? Did your practitioner recheck that lab in Jan when you had the B-12 checked? Were your hemoglobin and hematocrit low? Also your vitamin D level was 56? That's not really low based on the value you listed (Vitamin D3,25-OH range is 20-150 nmol/L or 8-80ng/mL). I'm not sure if your in the US or not, and the lab values may be different is you're not, they can even vary from lab to lab. As to your acne issue, I would not try to fix that with supplements at the moment. I would get your labs re-checked and may sure that is all sorted, that is really your priority at the moment. Once you are square there I would see a dermatologist, or some other skin care specialist to come up with a game plan. Supplements may not necessarily help you with that aside from prescription ones. Sorry for all the questions you've peaked my nerdly interest =-)

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 09:55 PM

I'm from Australia. Ferritin level was 31ug/L (30-300 range). Vitamin D waas 47nmol/L (51-140 range). Haemoglobin and Hematocrit were both perfectly fine. I'm not taking any supplements any more, I had D re-checked and it was fine after the 5000IU supplementation. Vitamin B12 was also now high since I also supplemented with that. It's been a while since I stopped taking supplements (Just CLO and 15mg Zinc now) so I can't wait to see how everything is looking.

-2
4cef120270c742b7f0094b05c617636f

on July 17, 2013
at 08:10 AM

Thank you for your generalised 'soccer mom' reply to my question that has absolutely 0 to do with what I asked.

First of all, if you even read anything I wrote you would see that I have already 'put down the pills'

I have been eating 'real food' for the past 12 months with zero preservatives, zero dairy, zero grains, zero bad or anything that I would even question as possibly bad. I'm in good shape, exercise regularly and lift weights 4 - 5 days a week so I don't know what the hell that is supposed to mean?

I fail to see your logic in saying my diet and supplementation scheme is 'random, disjointed and unorganized' when I have a perfect diet, excellent fitness, and didn't take any supplements bar what was necessary to get me out of the extremely low B12 problem (Which is serious, in case you didn't know).

You said you wouldn't expect B5 to much up my Fe or B12 either, care to share the sources you have based this conclusion on, especially regarding B12?

The shotgun approach to supplementation is what might have lead to my problem (with the B5 megadosing), but it is also what fixed the problem after I was diagnosed with an extremely low B12 level, contrary to the doctors ignorant orders of taking a 'safe' approach which wouldn't have done anything at the time for my B12 levels and would have caused me more problems in the long term.

So I don't know what the hell you're trying to say, or if you know anything at all, but it's pretty evident that you don't. I would appreciate it if someone who was actually knowledgeable and more technical would answer the following questions for me

  • What is the best B12 test?
  • What blood tests should I be taking in general for a good/accurate picture of my health?
  • What other tests can I take which might help me with troubleshooting my acne problem, considering my diet seems to be good?

Thank you :)

Edit: This is all in relation to the ridiculous answer the 'Matt' guy gave me (and also the person that agreed it was a good answer)

32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on July 17, 2013
at 11:19 AM

What do you expect? You left out a lot of detail except for excessive and capricious supplementation. I simply pointed out that you can't figure anything out supplementing like that.

4cef120270c742b7f0094b05c617636f

(181)

on July 17, 2013
at 09:40 PM

Sorry for scolding you Matt, I no longer hold resentment towards you and I am happy that you took the time to post in my thread.

75d65450b6ff0be7b969fb321f1200ac

(2506)

on July 17, 2013
at 12:16 PM

DopeFiend, most people who post answers are really trying to help. Yet in fact many answers are not helpful, unfortunately. I think it is proper (and appropriate) etiquette to thank people for their time and consideration rather than to scold them.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on July 17, 2013
at 11:51 AM

Matt, based on the evidence, all we can say is that excessive supplementation does not help figure out how to post a comment.

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