1

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What are the best labs for ~60 year old men?

Answered on August 19, 2014
Created July 03, 2012 at 7:53 PM

My father wants me to use one of those direct lab situations to order some basic tests for himself. The last time his doc ran a lipid panel was awhile ago - he put him on a low-fat diet that he dutifully followed, and saw his HDL drop to 17. He now eats a relatively healthy diet - I've pushed my mother toward more paleo eating and I'd say they're halfway there. He's teetering on the edge of doing a 30-day challenge, so this would be great for a baseline.

He's in great health outwardly - almost 60, trim and strong, can easily physically outdo men a couple decades younger. However, he worries often because his father, uncle, and grandfather on his paternal side died from heart attacks in their 50s. Even if I remind him that they ate unhealthily, were overweight, etc. - I know he just wants to see if there are any glaring issues a lab test might pick up. He's also irritated by losing muscle mass. Husband checked his BP and it was a bit high.

I've heard mixed issues with accuracy on NMR and VAP, so I was thinking basic lipid panel; TSH, free T4, T3 (he said he had his thyroid irradiated or something to shrink it when he was a kid and wonders about thyroid function); CMP/CBC with diff; Vit D; and some sort of hormone panel (need help here).

Anyone know what would be best to order here (I've read through some of the other threads but was looking for anyone with advice specific to middle-aged men with heart disease and thyroid worries)? I'm also ready to tear my hair out putting together the best-priced package, so if anyone has a favorite I'd appreciate that, too.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 04, 2012
at 02:01 AM

"And yes, I think it can be pointless or counterproductive to get calcium scores and NMR lipoprofiles and definitely standard lipid panels done at all. There are a useful things, maybe, but most of this stuff is just fuel for neurosis. More to come on this. Stay tuned." - Dr. McGuff "From that: Anyway, Dr. MCGuff did not expand on this, but I will later and I am delighted to find another MD willing to think such subversive thoughts." Dr. Harris

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 04, 2012
at 01:59 AM

Well I did qualify my answer with those ifs......so given the data you have shown in your comment, and YES the fact he is asking for them...of course proceed as needed. I would go as simple as need be though (hey I'm a proponent of limited testing = limited intervention). A bit of interesting stuff from both Dr. Harris and Dr. McGuff on the subject here http://www.archevore.com/panu-weblog/2010/2/22/body-by-science-and-panu.html. I know... I hate to invoke any sorts of outside source but the comment section is just too small and it expresses most my problems with the current paradigm.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 04, 2012
at 01:30 AM

If his total testosterone is OK but his Free testosterone is low then you might want to test SHBG but I its not necessary at first, IMO. AM Cortisol would also b useful now that I think about it. HgbA1C- most definitely.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 04, 2012
at 01:28 AM

He's wise to get the labs for sure. As a person with a thyroid disorder, I wonder how he has "survived" this long with an iradiated thyroid! Perhaps his thyroid gland is not fully annihilated... still low thyroid sucks. The cardiac CRP (be sure its the high sensitivity or cardiac one) is a very useful for test for looking at not only cardiac risk but GENERAL INFLAMMATION. If its too high, he can work to lower it with supplements and diet. All the best to you and your father.

1296f5fecd084f101d7c5fbe013f07eb

(1213)

on July 04, 2012
at 01:18 AM

Thanks! I wasn't sure whether anything besides the T total and free were useful like SHBG and what-not in terms of male hormones. I totally forgot about HgbA1C, too.

1296f5fecd084f101d7c5fbe013f07eb

(1213)

on July 04, 2012
at 01:15 AM

No docs or drugs. He is not a fan of either. I think he wants a baseline and to look for glaring issues. He does possibly have thyroid issues re: the irradiated thyroid gland; he can only sleep about six hours straight; he has chronic sinus drainage...like I said, he's on the edge of giving a whole 30 a go and has been making positive changes to his diet for the past year.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 04, 2012
at 12:14 AM

JayJay "lets not throw the baby out with the bath water" here. Getting labs does not and should not lead to Rx drugs and ignorance is not bliss! This man absolutely should have lab work done AND IS ASKING FOR IT! Denying that you have a problem does not mean that you don't have a problem. I totally disagree with your advice here. There are PLENTY of things he can do to improve the quality and length of his life addressing issues with inflammation or high blood sugar or pressure or low thyroid.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 03, 2012
at 10:11 PM

Totally disagree with this recommendation. If for instance his Vit D is low and or his CRP or HbA1C is high, then these are definitively things he can change. Labs do not and should not lead to Rx meds. Ignorance is not bliss. GET THE LABS and improve the quality of your life.

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2 Answers

1
4ef079c57d2140bba4dbf4e30240a645

on July 03, 2012
at 10:06 PM

Besides the usual metabolic and lipid panels make sure that you get:

Cardiac (high-sensitivity) CRP

Vita D level

HbA1C

Thyroid Panel (and if he is low then get tested for thyroid antibodies.)

Also good would be Total and Free testosterone.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 04, 2012
at 01:30 AM

If his total testosterone is OK but his Free testosterone is low then you might want to test SHBG but I its not necessary at first, IMO. AM Cortisol would also b useful now that I think about it. HgbA1C- most definitely.

1296f5fecd084f101d7c5fbe013f07eb

(1213)

on July 04, 2012
at 01:18 AM

Thanks! I wasn't sure whether anything besides the T total and free were useful like SHBG and what-not in terms of male hormones. I totally forgot about HgbA1C, too.

0
3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 03, 2012
at 08:49 PM

If his lifestyle is congruent with health...i.e. he eats mostly primal/paleo, gets good movement in on a regular basis, has no problems with sleep or his day/night cycle, and has a positive outlook on life.....the best test is NONE! Prevent overzealous doctors from scaring the crud outa him and reducing his lifespan and/or quality of life with their crap drugs by skipping the whole scene.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 04, 2012
at 12:14 AM

JayJay "lets not throw the baby out with the bath water" here. Getting labs does not and should not lead to Rx drugs and ignorance is not bliss! This man absolutely should have lab work done AND IS ASKING FOR IT! Denying that you have a problem does not mean that you don't have a problem. I totally disagree with your advice here. There are PLENTY of things he can do to improve the quality and length of his life addressing issues with inflammation or high blood sugar or pressure or low thyroid.

1296f5fecd084f101d7c5fbe013f07eb

(1213)

on July 04, 2012
at 01:15 AM

No docs or drugs. He is not a fan of either. I think he wants a baseline and to look for glaring issues. He does possibly have thyroid issues re: the irradiated thyroid gland; he can only sleep about six hours straight; he has chronic sinus drainage...like I said, he's on the edge of giving a whole 30 a go and has been making positive changes to his diet for the past year.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 03, 2012
at 10:11 PM

Totally disagree with this recommendation. If for instance his Vit D is low and or his CRP or HbA1C is high, then these are definitively things he can change. Labs do not and should not lead to Rx meds. Ignorance is not bliss. GET THE LABS and improve the quality of your life.

4ef079c57d2140bba4dbf4e30240a645

(4413)

on July 04, 2012
at 01:28 AM

He's wise to get the labs for sure. As a person with a thyroid disorder, I wonder how he has "survived" this long with an iradiated thyroid! Perhaps his thyroid gland is not fully annihilated... still low thyroid sucks. The cardiac CRP (be sure its the high sensitivity or cardiac one) is a very useful for test for looking at not only cardiac risk but GENERAL INFLAMMATION. If its too high, he can work to lower it with supplements and diet. All the best to you and your father.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 04, 2012
at 02:01 AM

"And yes, I think it can be pointless or counterproductive to get calcium scores and NMR lipoprofiles and definitely standard lipid panels done at all. There are a useful things, maybe, but most of this stuff is just fuel for neurosis. More to come on this. Stay tuned." - Dr. McGuff "From that: Anyway, Dr. MCGuff did not expand on this, but I will later and I am delighted to find another MD willing to think such subversive thoughts." Dr. Harris

3846a3b61bc9051e4baebdef62e58c52

(18635)

on July 04, 2012
at 01:59 AM

Well I did qualify my answer with those ifs......so given the data you have shown in your comment, and YES the fact he is asking for them...of course proceed as needed. I would go as simple as need be though (hey I'm a proponent of limited testing = limited intervention). A bit of interesting stuff from both Dr. Harris and Dr. McGuff on the subject here http://www.archevore.com/panu-weblog/2010/2/22/body-by-science-and-panu.html. I know... I hate to invoke any sorts of outside source but the comment section is just too small and it expresses most my problems with the current paradigm.

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