Author Topic: DIY preventative healthcare: blood tests!  (Read 6229 times)

acroy

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DIY preventative healthcare: blood tests!
« on: September 22, 2015, 01:02:10 PM »
I’m a proactive kind of guy and turned 38 this year. Looking to take more actions to monitor my health. I’ve just started researching blood testing and analysis. Apparently lots of folks run around with chronic low levels of various vitamins and minerals. Blood tests can catch this easily and are not very spendy.

So here’s the questions:
1)   Anyone do this?
2)   Any suggested guide for which tests and how to analyse?
3)   Any suggestion on how to go about it, recommended providers… – i.e. I am OK *not* going to my doc to get the order, as then I have to pay the doc *and* for the bloodwork.

Here’s a link to a provider:
http://www.walkinlab.com/home-lab-test-kits.html
they have a $hit-ton of tests available. Lots to sort through!

lbmustache

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Re: DIY preventative healthcare: blood tests!
« Reply #1 on: September 22, 2015, 02:05:08 PM »
I did this before, thankfully with the plan I had it was $40 copay (to see DR) and $18 for the bloodwork. I have had everything tested at some point lol - hormones, electrolytes, B vitamins, iron, Vitamin C, D, etc.

Everything was okay except for iron, which I already knew about (been anemic for a long time). My understanding is that if you eat a reasonably healthy diet and don't have any adverse health affects that indicate a problem (fatigue, nails that easily break, bruising, etc.) you are probably ok.

COlady

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Re: DIY preventative healthcare: blood tests!
« Reply #2 on: September 22, 2015, 02:12:42 PM »
Do you have insurance? Generally blood work falls under preventative care in combination with a physical.  Most insurance companies cover preventative care 100%, no need to meet your deductible.

acroy

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Re: DIY preventative healthcare: blood tests!
« Reply #3 on: September 22, 2015, 03:04:10 PM »
Yes I have insurance; it pays for 1 check up a year, but not bloodwork.
they poke and prod and put me on a scale and tell me how tall I am. whoopie! They tell me nothing I don't know.

LAGuy

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Re: DIY preventative healthcare: blood tests!
« Reply #4 on: September 22, 2015, 03:10:27 PM »
This is what I actually do for a living. Work in a hospital based laboratory running blood tests. I'd say services like these are a waste of time and money. Blood work isn't going to tell you anything, unless you're otherwise not feeling well or are "sick." They're just clues for doctors to suss out whatever is wrong with you.

See, if you're otherwise healthy and purchase this service, invariably some blood test is going to be "out of the normal range." But, what is normal? In the lab business normal is usually defined by taking a bunch of healthy people, testing their blood, and then saying the range that 95% of them get is "normal." However, 5% of those healthy people still had "out of the normal range." But they're still healthy. Nothing wrong with them.

Friends will often come to me with their lab tests that the doctor mailed to them or something without having gone over it with them. Often, they're alarmed because something is out of range. "OMG, this test says my urine specific gravity is out of the normal range. What does it mean?!" And I'm like, "Um, I dunno...did you drink a bunch of water to pee?" This is the kind of stuff you have to deal with if you choose to go a do it yourself route. I agree with the above comment. Your insurance probably covers this anyways. Just have it done at the doctors office and let them have a look at it for you, but don't expect blood tests to tell you anything unless you have a specific issue/complaint.

acroy

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Re: DIY preventative healthcare: blood tests!
« Reply #5 on: September 23, 2015, 06:48:22 AM »
This is what I actually do for a living. Work in a hospital based laboratory running blood tests. I'd say services like these are a waste of time and money. Blood work isn't going to tell you anything, unless you're otherwise not feeling well or are "sick." They're just clues for doctors to suss out whatever is wrong with you............ don't expect blood tests to tell you anything unless you have a specific issue/complaint.

Thanks LAGuy - exactly the kind of information I was hoping for!
Question for you: your mindset seems to be 'treat the illness'. I want to be preventative.
ON my cars I do used oil analysis to catch things before it becomes a problem. On myself, I want to do blood analysis to do the same thing.
 I don't want to wait till I'm sick!
Is this idea entirely without merit?

Gin1984

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Re: DIY preventative healthcare: blood tests!
« Reply #6 on: September 23, 2015, 06:58:22 AM »
This is what I actually do for a living. Work in a hospital based laboratory running blood tests. I'd say services like these are a waste of time and money. Blood work isn't going to tell you anything, unless you're otherwise not feeling well or are "sick." They're just clues for doctors to suss out whatever is wrong with you............ don't expect blood tests to tell you anything unless you have a specific issue/complaint.

Thanks LAGuy - exactly the kind of information I was hoping for!
Question for you: your mindset seems to be 'treat the illness'. I want to be preventative.
ON my cars I do used oil analysis to catch things before it becomes a problem. On myself, I want to do blood analysis to do the same thing.
 I don't want to wait till I'm sick!
Is this idea entirely without merit?
I had refrained from posting on this thread because based on my research experience (not medical), it did seem without merit.  The information in the blood tests (even assuming the tests are accurate which based on looking at them I don't think they are) needs to be combined with other data to be useful. Plus this is not preventive, if the blood tests are showing as an issue (and it is an issue) then it is an illness situation.  With some exceptions, like lack of Vitamin D can take time before we know it harms someone.  And so forth.  Is there a reason you don't want to use a real lab for this?

Left

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Re: DIY preventative healthcare: blood tests!
« Reply #7 on: September 23, 2015, 07:02:00 AM »
That's how it works over time too... it's the trends you watch for... even if it is still inside the normal range, if you see it creeping up/down over the years, you should watch it. Even if you are naturally high or low, if you trend into the normal range, that isn't good either because you aren't naturally at those levels.

Problem is that the creep may happen in small enough increments that you might not notice it without graphing it out. Mostly, I can't get a good grasp of it seeing it as numbers, but on a graph i can just look at the dots and see if they are trending up/down. Some of it is just getting older, and nothing to worry about, other might not be. If you go to the doctor on a regular basis, he is looking at it too (unless you shop doctors and they might not have years of history on you).

Most of the things in a basic metabolic should stay fairly constant, same with a hemogram (but even that isn't "constant" in that stress affects them too) Not enough to cause it to be worrying but they can jump around and if you just look at it yourself and see oh, my wbc just doubled from 5 to 12, I have a problem... maybe, maybe not, could be just allergies or something or you pulled a few late nights prior to the test. But they are still in the normal range too. Liver/Lipid tests jump around when you eat and other things, these are useful but again, the numbers by themselves while good for treatment isn't good for diagnosing on their own because so many things can affect them.

The idea of monitoring your own results is fine, it's just it causes unneeded stress too when you start to self diagnose. If going this route, you could just look at trends, and if you notice it, then at the next annual appointment just bring it up with doctor and ask him about it. Unless you were told to watch for something, it most likely is something that can wait until then, so you don't need to rush and call an emergency appointment with him.

Quote
Is there a reason you don't want to use a real lab for this?
I'm fairly certain the labs the the results are coming from are real... it's more of a problem of not having a real expert interpreting it...
« Last Edit: September 23, 2015, 07:11:27 AM by eyem »

iknowiyam

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Re: DIY preventative healthcare: blood tests!
« Reply #8 on: September 23, 2015, 07:06:00 AM »
Want prevention? Get a lipid panel. Next time you go for your annual check up, ask for lipid panel; they be fine with this and draw blood.

Gin1984

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Re: DIY preventative healthcare: blood tests!
« Reply #9 on: September 23, 2015, 07:10:06 AM »
That's how it works over time too... it's the trends you watch for... even if it is still inside the normal range, if you see it creeping up/down over the years, you should watch it. Even if you are naturally high or low, if you trend into the normal range, that isn't good either because you aren't naturally at those levels.

Problem is that the creep may happen in small enough increments that you might not notice it without graphing it out. Mostly, I can't get a good grasp of it seeing it as numbers, but on a graph i can just look at the dots and see if they are trending up/down.

Some of it is just getting older, and nothing to worry about, other might not be. If you go to the doctor on a regular basis, he is looking at it too (unless you shop doctors and they might not have years of history on you). I only brought it up because I think some people try it anyways. You will just cause yourself to worry more.

Most of the things in a basic metabolic should stay fairly constant, same with a hemogram (but even that isn't "constant" in that stress affects them too) Not enough to cause it to be worrying but they can jump around and if you just look at it yourself and see oh, my wbc just doubled from 5 to 12, I have a problem... maybe, maybe not, could be just allergies or something or you pulled a few late nights prior to the test. But they are still in the normal range too.

The idea of monitoring your own results is fine, it's just it causes unneeded stress too when you start to self diagnose. If going this route, you could just look at trends, and if you notice it, then at the next annual appointment just bring it up with doctor and ask him about it. Unless you were told to watch for something, it most likely is something that can wait until then, so you don't need to rush and call an emergency appointment with him.

Quote
Is there a reason you don't want to use a real lab for this?
I'm fairly certain the labs the the results are coming from are real... it's more of a problem of not having a real expert interpreting it...
Have you check out some of the kits? Some of them don't seem like they could be done accurately at home.  Granted this is from bench top not clinical experience but for myself I'd want someone with training do these not a kit.  Especially with the blood work, not everyone knows aseptic techniques. 

Left

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Re: DIY preventative healthcare: blood tests!
« Reply #10 on: September 23, 2015, 07:18:16 AM »
Have you check out some of the kits? Some of them don't seem like they could be done accurately at home.  Granted this is from bench top not clinical experience but for myself I'd want someone with training do these not a kit.  Especially with the blood work, not everyone knows aseptic techniques. 
I don't use the kits... I work in a hospital lab, I ran my own labs (we are allowed on a regular [qaurterly] basis, or volunteer myself when setting normal ranges). I'd assume that the kits are sent out so they are run on the full analyzers by either Quest or Labcorp (seems like those two have the corner on the market). But the sample may not be a "quality" specimen if the person doesn't collect it/ship it correctly either. Then again, some of the rapid tests are the pretty much the same as sold in stores. Like the pregnancy one. I do wish they sold rapid flu kits in stores during flu season, would be helpful, but I'm not sure they want the liability of it.

Or if they are using point of care analyzers to get results in minutes (I'm not sure they do this but I haven't tried the kits...). Those poc instruments are pretty good at the normal range but some tests get inaccurate at the low and high ends. I don't have too much of a problem with it being used for this though, yes I like accurate results but a high result is a high result, example is if it high at >100 but machine reads 150 vs 180 on a full analyzer, yes the doctor cares that it is 180 and not 150 because he is treating off it. You as a patient doesn't really care, you just need to know it is >100 and high, then you can follow up with doctor.

But again, one result doesn't determine anything, just like you can't make a "line" with 1 dot, you can't make a diagnosis with one or even two data points. And even if you have a handful of data, if the clinical presentation isn't there, it isn't there, you just run "high". Normal ranges are established based on the population sample they used, it doesn't mean it is "normal" to you, or anything. If you are the only ethnically different person in town, then the normal ranges weren't established with you in mind,... doesn't mean your values are going to be wrong  but you might hit the low/high ends just because you aren't "normal" within their established ranges

hate to post a link to companies I haven't used before/or can't vouch for... but they seem legit, seems so do own research before using
http://www.privatemdlabs.com/
« Last Edit: September 23, 2015, 07:38:38 AM by eyem »

sheepstache

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Re: DIY preventative healthcare: blood tests!
« Reply #11 on: September 23, 2015, 07:28:57 AM »
Since you have insurance, you should see what the negotiated rates are for the tests you want. I just had a panel of seven tests done and the insurance didn't pay for them since I haven't hit the deductible yet but it was only 90 bucks. The list price would have been 800.

Sibley

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Re: DIY preventative healthcare: blood tests!
« Reply #12 on: September 23, 2015, 07:38:26 AM »
General rule of thumb for health: Eat a healthy, balanced diet. Get plenty of exercise. Get adequate sleep. Don't sweat the small stuff.

Now, where does this obsession of yours with getting blood work for preventative care fall into that? That's right, sweating the small stuff. Unless and until there's a solid reason to worry, let it go. (que Frozen music...)

Left

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Re: DIY preventative healthcare: blood tests!
« Reply #13 on: September 23, 2015, 07:41:11 AM »
General rule of thumb for health: Eat a healthy, balanced diet. Get plenty of exercise. Get adequate sleep. Don't sweat the small stuff.

Now, where does this obsession of yours with getting blood work for preventative care fall into that? That's right, sweating the small stuff. Unless and until there's a solid reason to worry, let it go. (que Frozen music...)
I'd say the same with vitamins too... unless you are missing one in particular, there is really no need to eat extra vitamins... and yet look how many pills are sold

frugaldrummer

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Re: DIY preventative healthcare: blood tests!
« Reply #14 on: September 23, 2015, 08:27:52 AM »
Tests for a 38 year old man who wants to be proactive:

Comprehensive metabolic panel (fasting blood sugar, electrolytes, liver , kidneys)
CBC - blood count.
Vitamin D
VAP panel - cholesterol test that includes particle size

Homocysteine, CRP - independent risk factors for heart disease. Ekevated homocysteine can be due to B vitamin deficiencies or methylation pathway defects that prevent you from using B12 and folate well.

Iron/tibc or transferrin saturation test - genetic iron overload, called hemochromatosis, is a preventable cause of diabetes, heart disease and cirrhosis of the liver. Present in 1/200 people but often missed until too late. Treatment involves frequent blood donation to keep iron levels down. (Ferritin is also used to screen for this but in my experience not as accurate).

Other tests might depend on family history or your symptoms.

bo_knows

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Re: DIY preventative healthcare: blood tests!
« Reply #15 on: September 23, 2015, 08:45:09 AM »

VAP panel - cholesterol test that includes particle size


I wanted to emphasize this. The standard lipid panel is vastly inferior to the VAP panel.  There is a ton of research out there stating that a simple LDL/HDL test can't really tell you much about heart disease risk.  You could have a high LDL (the "bad cholesterol") but still be very very low risk at Cardiovascular disease. Why, may you ask? Because there are different subcategories of LDL, and the "big fluffy" kind of LDL is actually very good for your body, even if you have a lot of it.

Long story short: Get the VAP.

acroy

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Re: DIY preventative healthcare: blood tests!
« Reply #16 on: September 23, 2015, 08:48:37 AM »
Thanks for all the replies!

Cost: I have a high-deducible plan and have the joy of paying 100% out of pocket till deductible is met (not met yet this year). No insurance love there. The cost for the tests will of course apply to the deductible

Other health factors: My family and I eat well, sleep well, get lots of exercise. There is family history of heart issues on both parents sides, immune issues (gnarly allergies, some of which I have) and hemochromatosis (thanks frugaldrummer for mentioning, I had actually forgotten!!). I'd call myself healthy but with some risk factors.

Reliability of test results: this is why I posted here and started asking Google some questions. Great information!

Analysis of test results: Also why I posted here and queried google ;)

Value of results: Again, why I posted here. I envisioned starting a periodic test schedule (every 6-12 months) and start tabulating the results. It's not very expensive and 'can't hurt' to help catch such things as hemochromatosis, low vitamins or minerals.

Anecdotal value:
1)a co-worker suffered from a 'sensitive stomach' for decades. Turned out she had mild celiac... discovered at age 59 with a simple blood test.
2) co-worker suffered from mild aches and cramps for years. Turned out she was low on potassium; simple blood test.
3) The Blackstone Labs newsletter, this is actually what got me thinking http://www.blackstone-labs.com/Newsletters/Gas-Diesel/August-1-2015.php

The_path_less_taken

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Re: DIY preventative healthcare: blood tests!
« Reply #17 on: September 23, 2015, 08:53:10 AM »
They have to outrun me to perform blood tests, since I hate needles.

But I agree with the OP: there are now various 'markers'....

(it was an old article and I have not had caffeine yet today...bear with me)


...like (I think) CA125 and others that indicate cancer and other health issues....thyroid is one as well...there's one for prostrate as well, can't recall it though.

So if you can stand a ginormous needle draining your life away (ick), go for it. I can see where having one every 5 years or so might be helpful, for a chart purpose.

It's not like you're saying you want to buy a Ferrari: I think it could be a useful diagnostic tool for your doc, and your peace of mind.

geekette

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Re: DIY preventative healthcare: blood tests!
« Reply #18 on: September 23, 2015, 09:15:29 AM »
Unless you have a non-ACA compliant insurance plan, you get a physical and labs included every year. The prices for those labs, without a doctor's interpretation, look higher than my insurance company's negotiated rates.


Ambergris

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Re: DIY preventative healthcare: blood tests!
« Reply #19 on: September 23, 2015, 10:11:13 AM »

VAP panel - cholesterol test that includes particle size


I wanted to emphasize this. The standard lipid panel is vastly inferior to the VAP panel.  There is a ton of research out there stating that a simple LDL/HDL test can't really tell you much about heart disease risk.  You could have a high LDL (the "bad cholesterol") but still be very very low risk at Cardiovascular disease. Why, may you ask? Because there are different subcategories of LDL, and the "big fluffy" kind of LDL is actually very good for your body, even if you have a lot of it.

Long story short: Get the VAP.

Not quite right: the actual studies done on this (of which there are a few) suggest that having lots of both particle types of LDL increase your risk of heart disease (or correlates of it like arterial blockage) relative to having fewer. However, having your overall LDL concentration composed of big particles increases your risk less than having that concentration composed of small ones: this may be because when your LDL is composed of big particles, you get fewer of them; it may be because little LDLs oxidize more easily. For some reason some online health gurus have managed to turn this into "big LDL is good for you and little is bad for you", which is wrong: you want both numbers down. Nevertheless, it might be somewhat helpful to know if you are prone to make a larger proportion of small particles due to your increased risk.

frugaldrummer

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Re: DIY preventative healthcare: blood tests!
« Reply #20 on: September 23, 2015, 10:20:01 AM »
If you have a family history of hemochromatosis, consider getting a hemochromatosis gene test as well to determine your risk. Most people with just one copy of the gene are asymptomatic (although I have seen a few who still get moderately iron overloaded, probably due to some additional gene that we don't test for).  If you have two copies of the genes, EVEN IF your iron levels are normal now, you are at increased risk of developing iron overload and should keep a close eye on it.   

CA 125 is a test for ovarian cancer, so will be useless for the original poster.  It also is NOT a good general screening test - it can be positive in a lot of benign conditions like fibroids and endometriosis, and lead to a lot of unnecessary procedures.  However, I would consider using it for screening in a HIGH RISK patient, someone with a family history of ovarian cancer or known BRCA genes or Lynch syndrome.

If you have a family history of autoimmune disorders (celiac disease, thyroid disease, rheumatoid arthritis, lupus, MS etc) then additional testing should be directed in that corner.  The standard celiac panel only picks up the worst-of-the-worst cases, full-blown celiac disease, and will miss many people with significant gluten intolerance.

bludreamin

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Re: DIY preventative healthcare: blood tests!
« Reply #21 on: September 23, 2015, 10:42:33 AM »
For what it's worth (probably little since it's a data point of one), I recently decided to get a PCP and went in for a visit. Based on some of my conditions the Dr had me get blood drawn and tested. I'm also on a high deductible health plan (yay for HSA investment vehicle) so I was expecting to post everything out of pocket. Well I got the visit EOBs today. As expected I have to pay for time with Dr (new patient visits are expensive) but insurance covered all but $16 of the $330 billed for lab work (13 line items). Unfortunately the EOB didn't include what tests so I'll have to wait for the follow-up visit and/or bills to come.

TL;DR - try calling for insurance to see what they cover as preventative - you may be surprised.

LAGuy

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Re: DIY preventative healthcare: blood tests!
« Reply #22 on: September 23, 2015, 10:45:39 AM »
Anecdotal value:
1)a co-worker suffered from a 'sensitive stomach' for decades. Turned out she had mild celiac... discovered at age 59 with a simple blood test.
2) co-worker suffered from mild aches and cramps for years. Turned out she was low on potassium; simple blood test.
3) The Blackstone Labs newsletter, this is actually what got me thinking http://www.blackstone-labs.com/Newsletters/Gas-Diesel/August-1-2015.php

I think your anecdotes are pretty much telling you what Eyem and myself already told you. Your lab results are useless without a doctor to interpret them.

"My potassium is low! A ha! That's why I've had these aches and cramps for years!" Said, um nobody ever. It took a doctor figure that out. Certainly the lab didn't figure that out with their tube of blood and computer printout.

"My stomach hurts. Must be celiac. I'll order a celiac panel for myself." Right. All kinds of reasons why your stomach hurts. Maybe tell your doctor that your stomach hurts, they'll start to investigate the many possible causes of why that may be.

There's lots of reasons why things may be out of range that have nothing to do with disease as well. For instance, high potassium could indicate kidney problems. Or, it could simply be that the quality of the draw was bad - i.e. the blood draw is "hemolyzed" - somebody with butterfingers caused a bunch of trauma to your blood cells during blood draw, the cells burst open and leak out all of their goodies for the lab machines to pick up. A doctor is going to know to correlate those potassium results with serum creatinine and BUN results.

MayDay

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Re: DIY preventative healthcare: blood tests!
« Reply #23 on: September 23, 2015, 10:47:14 AM »
On the subject of at-home lab tests, I recently bought a strep test kit from Amazon.

Basically, every winter various family members get horribly sore throats, with or without the other typical strep symptoms.  In my case in particular, I don't get the typical strep symptoms, so its hard to know if I should go in.

So every time we get a sore throat, either we have to go in to the doctor and get exposed to a million other germs in the winter, waste an hour and 100$.

Or we wait 3-4 days and see whether we get better or get sicker and sicker. 

So now I can just swap throats daily until they feel better or show strep.  And go in once I know we actually need the drugz.  All it will take is avoiding one unnecessary dr. visit to more than pay for the kit.

hops

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Re: DIY preventative healthcare: blood tests!
« Reply #24 on: September 23, 2015, 11:10:36 AM »
If you have a family history of autoimmune disorders (celiac disease, thyroid disease, rheumatoid arthritis, lupus, MS etc) then additional testing should be directed in that corner.  The standard celiac panel only picks up the worst-of-the-worst cases, full-blown celiac disease, and will miss many people with significant gluten intolerance.

If you have symptoms of those diseases, testing obviously makes sense. But diagnosis can be tricky, autoimmune diseases are notorious for their overlapping symptoms (and the ways they're related: if you have one autoimmune disorder, you're more likely to get another) and properly diagnosing one is rarely a DIY proposition. The results need to be paired with physical examination and possibly other testing to provide the whole picture. If you order your own labs, notice something wonky and then take the results to a specialist, he or she will probably reorder the blood work anyway.

To further complicate things, you can have seronegative autoimmune diseases or, as others have mentioned, blood work that looks abnormal but doesn't mean anything (some people have a positive ANA or rheumatoid factor but no disease, or they're HLA-B27 positive but don't have AS, etc.). Blood work is tricky and the best thing for your pocketbook and health (mental and physical) is to let a professional order and interpret your labs. Insurance, even high-deductible plans, will probably cover more than you anticipate.

« Last Edit: September 23, 2015, 11:40:16 AM by hops »

LAGuy

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Re: DIY preventative healthcare: blood tests!
« Reply #25 on: September 23, 2015, 11:21:55 AM »
On the subject of at-home lab tests, I recently bought a strep test kit from Amazon.

Basically, every winter various family members get horribly sore throats, with or without the other typical strep symptoms.  In my case in particular, I don't get the typical strep symptoms, so its hard to know if I should go in.

So every time we get a sore throat, either we have to go in to the doctor and get exposed to a million other germs in the winter, waste an hour and 100$.

Or we wait 3-4 days and see whether we get better or get sicker and sicker. 

So now I can just swap throats daily until they feel better or show strep.  And go in once I know we actually need the drugz.  All it will take is avoiding one unnecessary dr. visit to more than pay for the kit.

That's not a bad idea, and the strep test is super easy to do. Not all at home testing is bad if you have a specific reason to do so. Pregnancy test dip sticks are another example. Perhaps HIV testing (if you don't screw it up). Glucose testing for diabetics.

But forget about tracking numbers and trends. Maybe the methodology or instrumentation changed. Perhaps a new lot number of reagents is in use. Maybe the air conditioning in the lab broke that day, and the higher temperatures threw the instrumentation off just a tad. Maybe some dumb ass put the wrong label on your tube. People put way too much faith in lab testing - same thing with juries and DNA testing.