Dr.PeteFamMed said:The single most useful discipline is bringing the whole panel to a clinician rather than one flagged value.
Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. I would drop the "get everything" instinct further than this thread does. Every extra test is another chance at a false positive, and incidental findings have their own cost in scans, biopsies and worry.
sophie_paris said:I got a full panel before starting and a repeat at three months, and the second one is more useful than the first purely because I now have something…
PSA: get baseline labs BEFORE starting baseline bloodwork therapy. You need a "before" picture to measure progress. My recommended pre-treatment panel:
- CMP + A1C + fasting insulin
- Complete lipid panel with particle count if possible
- hsCRP, ferritin, B12, vitamin D
- Thyroid panel (TSH + free T4)
- CBC with differential
- Liver panel (ALT, AST, GGT)
- DEXA scan or body composition
Total cost at Quest without insurance: ~$200. Worth every penny for the data.
kate.chem said:I would drop the "get everything" instinct further than this thread does.
Adding the part of the answer the thread has not reached. ApoB is the more informative number and it is cheap. LDL-C estimates cholesterol mass in atherogenic particles; ApoB counts the particles, and it is particle count that tracks risk — which is why the two can disagree and why the disagreement is the clinically interesting case. Triglycerides fall substantially with weight loss and improved insulin sensitivity, HDL moves modestly, and LDL-C often barely moves at all, which surprises people who expected everything to improve together.
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Shop Reference StandardsOne thing that is still open after JakeSmashed95’s answer:
How often to repeat it, because quarterly seems to be the convention and I cannot find the reasoning?
Reporting back.
Took the whole panel in rather than the one flagged line, and the conversation lasted two minutes instead of generating three more tests.