1

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What's with all the blood work?

Answered on September 12, 2014
Created July 31, 2012 at 2:30 AM

I've noticed that a lot of people here get blood work done, and I'm not sure what relation this has to eating paleo. For what reasons should someone get blood work done, and what labs do people request when they do it? How do they interpret the data? What exactly are people looking for in their blood?

Baa413654789b57f3579474ca7fa43d7

(2349)

on August 01, 2012
at 05:49 PM

That counterargument is becoming more popular throughout medicine and is the basis for the recent somewhat controversial recommendations from some groups to conduct fewer mammograms, psa tests, etc. http://www.usatoday.com/news/health/wellness/story/2012-05-26/PSA-test-fewer-health-screenings/55218576/1

A968087cc1dd66d480749c02e4619ef4

(20436)

on August 01, 2012
at 05:28 PM

Yes, I agree with you as well. Vitamin D, iron levels, crp, thyroid might all be useful. Thyroid seems to be one that doctors misread. I just wanted to present a rather intelligent counter argument by a real doctor. The idea that on an aggregate basis, testing may do more harm than good, presumably by leading to unnecessary treatment (say statins) that have negatives consequences (muscle pain, memory loss, cancer).

A968087cc1dd66d480749c02e4619ef4

(20436)

on August 01, 2012
at 05:27 PM

Yes, I agree with you as well. Vitamin D, iron levels, crp, thyroid might all be useful. Thyroid seems to be one that doctors misread. I just wanted to present a rather intelligent argument by a doctor. The idea that on an aggregate basis, testing may do more harm than good, presumably by leading to unnecessary treatment (say statins) that have negatives consequences (muscle pain, memory loss, cancer).

Baa413654789b57f3579474ca7fa43d7

(2349)

on August 01, 2012
at 02:21 PM

I agree with the Doug McGuff quote up to a point. There is a lot of variability in what is healthy, even within Paleo. If everyone was the same then everyone could "eat healthy" and be fine. But everyone comes to Paleo with a different background and health status. Nightshades might be perfectly healthy for one person and not another. Someone with a broken metabolism might do better by reducing carbohydrates. Sometimes testing can reveal a problem (such as poor thyroid function) that you don't even know you have. Testing may give clues about what to tweak within an otherwise healthy diet.

A968087cc1dd66d480749c02e4619ef4

(20436)

on August 01, 2012
at 01:55 PM

"If the number is bad, eat healthy, and if the number is good, eat healthy. What do you need the number for?" See my answer below... (The one thing that is worth getting tested is your vitamin D levels.)

61844af1187e745e09bb394cbd28cf23

(11058)

on July 31, 2012
at 12:52 PM

He swears they are safe and was visibly irritated when I told him I never picked the prescription up from the pharmacy. My HDL is low (39)and my (calculated) LDL is high (117), but Trigs were 100 and total was 170 (I think). I'll work on raising my HDL. His advice was, of course, to eat whole grains (a death sentence for a diabetic) and avoid sat fats. NO THANK YOU!

C45d7e96acd83d3a6f58193dbc140e86

on July 31, 2012
at 12:38 PM

Or to prove what's right

B3173217a49b5b0116078775a17eb21d

(11488)

on July 31, 2012
at 10:43 AM

Blood work or not, the fact that you are a woman makes your doctor's push to put you on statins ill-advised.

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7 Answers

3
05055dcbf12c81f1cce777ec365870af

(1791)

on July 31, 2012
at 04:52 AM

measuring data to track progress or figure out what's wrong.

C45d7e96acd83d3a6f58193dbc140e86

on July 31, 2012
at 12:38 PM

Or to prove what's right

2
6bce08b072e3cea49b292658b9d5d197

on July 31, 2012
at 06:13 AM

dshohei hit it on the head. The blood work to to more or less "prove" to yourself that you've been lied to for all these years.

Eating the saturated fats and proteins while forgoing the wheat and grains WILL improve your blood panels. So if possible, get a work up done before you start, then after a month or two and see the results for yourself. It's pretty amazing actually.

http://www.jbprimal.com

2
78964c5cc470f86a5897db8e1ce8e6f9

on July 31, 2012
at 03:04 AM

Well, some people get blood work done in the course of regular doctor's visits. Others may have had high cholesterol or nutrient deficiencies that they want to retest after being on a paleo diet for a while.

Common blood tests done are the basic metabolic panel (electrolytes and kidney tests), comprehensive metabolic panel (that plus protein and liver tests), fasting cholesterol, fasting glucose.

1
A968087cc1dd66d480749c02e4619ef4

(20436)

on August 01, 2012
at 01:56 PM

Well, that's an interesting question to which I would refer you (yet again) to Dr. Harris for a contrarian view:

http://www.archevore.com/panu-weblog/2010/2/22/body-by-science-and-panu.html

It's about halfway down in the post where he is talking about Doug McGuff/Body by Science:

"At one point in the lecture, he hints that he does not believe in doing a lot of testing. He says, ???if the number is bad, eat healthy, and if the number is good, eat healthy???. What do you need the number for?

SIDEBAR:

This is profound, actually and I have been meaning to blog on this for a while. I think he is using a heuristic that could, when coupled with having the consumers of health care actually be the ones paying for it, slash our health care costs nationally by more than half, even if everyone kept eating the SAD. The biggest myth in all of medicine is that doing something is always better than doing nothing, with the corollary that there is always some marginal non-negative benefit to every test and procedure. I believe this is profoundly mistaken.

The average medical service diagnostic or therapeutic, may actually not only not have a positive net benefit, but may have a net negative one.

Yes, I actually said that. So there is some ???man bites dog??? medical heresy for you to chew on.

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."

Baa413654789b57f3579474ca7fa43d7

(2349)

on August 01, 2012
at 02:21 PM

I agree with the Doug McGuff quote up to a point. There is a lot of variability in what is healthy, even within Paleo. If everyone was the same then everyone could "eat healthy" and be fine. But everyone comes to Paleo with a different background and health status. Nightshades might be perfectly healthy for one person and not another. Someone with a broken metabolism might do better by reducing carbohydrates. Sometimes testing can reveal a problem (such as poor thyroid function) that you don't even know you have. Testing may give clues about what to tweak within an otherwise healthy diet.

A968087cc1dd66d480749c02e4619ef4

(20436)

on August 01, 2012
at 05:27 PM

Yes, I agree with you as well. Vitamin D, iron levels, crp, thyroid might all be useful. Thyroid seems to be one that doctors misread. I just wanted to present a rather intelligent argument by a doctor. The idea that on an aggregate basis, testing may do more harm than good, presumably by leading to unnecessary treatment (say statins) that have negatives consequences (muscle pain, memory loss, cancer).

A968087cc1dd66d480749c02e4619ef4

(20436)

on August 01, 2012
at 05:28 PM

Yes, I agree with you as well. Vitamin D, iron levels, crp, thyroid might all be useful. Thyroid seems to be one that doctors misread. I just wanted to present a rather intelligent counter argument by a real doctor. The idea that on an aggregate basis, testing may do more harm than good, presumably by leading to unnecessary treatment (say statins) that have negatives consequences (muscle pain, memory loss, cancer).

Baa413654789b57f3579474ca7fa43d7

(2349)

on August 01, 2012
at 05:49 PM

That counterargument is becoming more popular throughout medicine and is the basis for the recent somewhat controversial recommendations from some groups to conduct fewer mammograms, psa tests, etc. http://www.usatoday.com/news/health/wellness/story/2012-05-26/PSA-test-fewer-health-screenings/55218576/1

1
Bb3d1772b28c02da2426e40dfcb533f5

(5381)

on July 31, 2012
at 09:33 AM

Partly as confirmation that your doing the right thing with a radical change in diet.

Partly because people get bloods done anyway, and conventional medicine often doesnt know how to interpret blood results which are lower carb, because all the literature and reference ranges are for people who eat loads of carbs. The body acts quite differently in lower carb, which is understood in science, but not typically encountered, or included in blood test protocol or reference ranges.

1
61844af1187e745e09bb394cbd28cf23

(11058)

on July 31, 2012
at 03:56 AM

I am T2 diabetic and had triglycerides around 300. I have blood work done every 3 months to prove to my doctor that his push for me to go on statins is ill-advised.

I have also always struggled with anemia, which seems to still be an issue. My blood work last week shows my iron levels are at the very bottom of "normal," and that is with eating liver once a week and taking a whole food iron tab every night. This time around, my vit D levels were also checked and found to be quite low. So, I will continue to tweak my diet and daily habits to find balance and will check everything again in 3 months.

61844af1187e745e09bb394cbd28cf23

(11058)

on July 31, 2012
at 12:52 PM

He swears they are safe and was visibly irritated when I told him I never picked the prescription up from the pharmacy. My HDL is low (39)and my (calculated) LDL is high (117), but Trigs were 100 and total was 170 (I think). I'll work on raising my HDL. His advice was, of course, to eat whole grains (a death sentence for a diabetic) and avoid sat fats. NO THANK YOU!

B3173217a49b5b0116078775a17eb21d

(11488)

on July 31, 2012
at 10:43 AM

Blood work or not, the fact that you are a woman makes your doctor's push to put you on statins ill-advised.

0
510bdda8988ed0d4b0ec0b738b4edb73

(20898)

on August 01, 2012
at 02:41 PM

I actually don't understand the obsession either. I always say that you should know exactly what you're going to do with the data that you get. As Dave S says, if it's good, eat healthy, if it's bad, eat healthy. Before you take any test you should have a whole list of things you're going to change based on where the number comes in (that can include, do nothing if the number is in a good range), but unless you're planning ahead like that, then you're just taking the test, getting a number, and essentially doing nothing with it. It may make you feel better to have the number, but it can also stress you out that things aren't "perfect", and if you have no plan on what you're going to do with that number, it's just not worth getting.

Also, even if the tests are 100% accurate at measuring what they say they're measuring (they're not, but error theory is too much to go into here), who's really to say what a good number is and what a bad number is? All we do is compare those values to other (probably sick people) and get averages. Or you have some drug lobby trying to push what's considered "good" to a place that no one achieves without meds (cholesterol is the best example of this).

Unless you're really sick and you're trying to get a handle on what to do or to see if you can track yourself getting better, I advocate getting away from blood tests, and just go with the good old: how do you look, feel, and perform.

Really, if anyone came here and posted a bunch of numbers and said "how do I fix this?" My response will be: eat lots of protein from clean sources, lots of saturated fat, minimize sugar, and vegetable oils, and eat no grains. Even if they had "perfect" numbers, I'd say the same thing.

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