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c/bloodwork·posted 1 year ago by u/burned_once_twice

the ApoB thing finally clicked for me and I want to write it down

Question Clean Column ×6 Slow Clap ×2 Cold Box ×2

the ApoB thing finally clicked for me and I want to write it down — a position I have arrived at slowly and would like tested.

Took a baseline the week before starting purely because this board told me to. Best five minutes I have spent on this.

Tracked triglycerides against the weight trend for a year. The correlation was much weaker than I expected and that was worth knowing.

How to make a panel worth comparing, which is most of the value people leave on the table.

Standardise the conditions: same lab, same fasting state, same rough time of day, same point in the week, similar hydration. Take a baseline before you change anything. Repeat any surprising value before acting on it. Change one thing at a time if you want to attribute anything to it.

Do that and a year of panels is a trend. Skip it and a year of panels is a collection of unrelated mornings, which is what most of the alarmed posts here are actually describing.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

4,094 up / 464 down90% upvoted63 commentsid 15qfr34 Oct 2024

63 comments

29 in this archive, depth 5

best — the order this archive was captured in

u/greta_chukwu489 points·1 year ago

Different laboratories use different assay platforms with different calibration. Comparing across labs adds a systematic offset that is invisible on the report.

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u/karl_fischer_kev392 points·1 year ago

Not convinced by the attribution. Weight loss alone moves that marker and you have no way to separate the two.

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u/burned_once_twiceOP-4 points·1 year ago

What did the repeat show?

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u/coa_forgery_watch1 point·1 year ago

Added ApoB to the panel after a thread here. It told me something the standard lipid panel had been hiding.

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u/micro_bump_mick1 point·1 year ago

Compared two draws across two labs and spent a week worrying before finding out the assays were different.

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u/gustav_cardoso1 point·1 year ago

one measurement is a point, two is a line, three is a trend

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u/a1c_arcT2D342 points·1 year ago

Time of day, fasting state, hydration and recent exercise all move common markers. Standardising the draw conditions is free and it removes most of the apparent variability.

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u/mikkel_ogunleye131 points·1 year ago

I would not draw a line through two points, especially when the second was taken at a different time of day.

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u/noor_hovland158 points·1 year ago

Substantial weight loss independently moves lipids, liver enzymes and several other markers. Attributing a change to a compound while losing weight is confounded by design.

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u/tidy_vialdrawer_watch98 points·1 year ago

That is a non-fasting value and the interval you are comparing it against is a fasting one.

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u/yara_mensah125 points·1 year ago

weight loss itself moves several of these independently

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u/coldchain_karencold chain45 points·1 year ago

hydration status moves a surprising number of markers

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u/santiago_szabo155 points·1 year ago

Disagree with reading anything into that. One value, one morning, and you changed two other things in the same window.

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u/burned_once_twiceOP77 points·1 year ago

Did anything else change in that window — training, intake, hydration?

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u/andres_restrepo50 points·1 year ago

That comparison crosses two labs with different assays. The difference you are describing may be the method.

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u/noor_hovland27 points·1 year ago

Yes. Repeat before you react. Almost every alarming single value I have posted here regressed on the repeat.

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u/lipid_panel_larrybloodwork117 points·1 year ago

ApoB counts atherogenic particles rather than the cholesterol they carry, which is why it can diverge from LDL-C and why it is the addition most worth making.

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u/laila_yilmaz34 points·1 year ago

Same view — ApoB if you add one thing. It answers a question the standard panel only gestures at.

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u/pavel_nkemelu16 points·1 year ago

Same view — ApoB if you add one thing.

laila_yilmaz is right that a reference interval is not a target. It is a description of a population.

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u/britt_marchand70 points·1 year ago·edited

Push back: a value just outside a reference interval is a common finding in healthy people. It is a reason to repeat.

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u/yara_antonsen42 points·1 year ago·edited

Push back: a value just outside a reference interval is a common finding in healthy people.

Disagreeing with this bit: that change is confounded by the weight loss itself and cannot be attributed.

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u/cardio_endpoint_c50 points·1 year ago

Why so many single values look alarming and turn out to be nothing.

A reference interval is built to contain about 95% of a healthy reference population, so one test in twenty falls outside one by construction. Add biological variation, assay imprecision, fasting state and time of day, and a genuinely stable person will produce occasional out-of-range results.

That is why repeat testing before acting is standard. Regression to the mean handles most of it. None of which means an out-of-range value should be ignored — it means it should be repeated and taken to somebody who can put it in context, which is emphatically not a ranked feed.

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u/micro_bump_mick21 points·1 year ago

This. Reference ranges are population intervals, not targets, and conflating them causes a lot of unnecessary alarm here.

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About c/bloodwork

What to measure before you start, what to re-measure, and how to interpret movement without panicking. ApoB over LDL-C, HOMA-IR as a crude free tool, ALT and the fatty-liver story, eGFR noise during rapid loss, and the deficiencies that a 1,100-calorie appetite will hand you.

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