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

reading lipids threads from 2024 and half of it aged badly

Question Receipts ×8

reading lipids threads from 2024 and half of it aged badly, which sounds obvious until you try to state the evidence for it.

Reference intervals are typically the central 95% of a reference population. By construction one person in twenty falls outside one on any given test without anything being wrong.

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

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.

Ask me anything specific. Anything general I will probably get wrong.

1,017 up / 248 down80% upvoted50 commentsid 14mhcb7 Dec 2024

50 comments

26 in this archive, depth 4

best — the order this archive was captured in

u/hedda_adeyemi121 points·1 year ago

Repeat testing before acting is standard practice for a reason: regression to the mean does a lot of work on single outlying values.

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u/anya_rautioOP86 points·1 year ago·edited

My A1c moved and I spent a fortnight convinced I knew why. The repeat six weeks later was back in range and I had changed nothing.

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u/milos_trevino104 points·1 year ago

Nobody here can interpret your panel and this comment is not doing so. What a board can usefully do is help you ask better questions of somebody who can.

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u/valeria_karlsen-37 points·1 year ago

Careful — that is a question for whoever ordered the panel, and nobody in this thread can answer it responsibly.

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u/kofi_balogun1 point·1 year ago

ask whether the lab changed its assay between your two draws

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u/lipid_panel_larrybloodwork1 point·1 year ago

draw at the same point in the week if you want comparability

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u/mariam_mensa34 points·1 year ago

the trend line matters more than any single value

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u/employer_carveout21 points·1 year ago

Do you have a baseline from before you started?

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u/mateusz_achebe92 points·1 year ago

Panicked about a single result, posted here, got told to repeat it, repeated it, and it was fine.

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u/a1c_arcMOD50 points·1 year ago·edited

Identifying header cropped from the report above. Post the values, not the name and reference number.

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u/chidi_abubakar28 points·1 year ago

Correction: that marker is reported in different units by different labs, which explains the tenfold difference you are seeing.

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u/freya_baptista12 points·1 year ago

same lab, same conditions, or you are comparing noise

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u/anya_rautioOP29 points·1 year ago·edited

Correcting my own comment: the two draws were 13 weeks apart, not the figure I gave earlier.

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u/peptidemeter_pat24 points·1 year ago

bring the numbers to someone qualified to read them

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u/hugo_pires55 points·1 year ago

baseline before you start is worth more than any later panel

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u/anya_rautioOP27 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/jonas_cardoso37 points·1 year ago

Small fix — a reference interval is not a treatment target, and the post above uses them interchangeably.

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u/lipid_panel_larrybloodwork30 points·1 year ago

The confounding problem, stated plainly, because this board keeps stepping on it.

Substantial weight loss moves lipids, liver enzymes, insulin sensitivity markers and several others in its own right. If you are losing weight while taking something, any change in those markers has at least two candidate explanations and you cannot separate them from your own panel.

What you can do is standardise, take a baseline, keep the series long, and be honest in your posts about what is and is not attributable. The threads that say "this compound did X to my triglycerides" almost never have the design to support the claim, mine included.

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[deleted]11 points·1 year ago

[deleted]

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u/yara_mensah6 points·1 year ago·edited

ApoB is the one worth adding if you only add one

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u/andres_restrepo4 points·1 year ago

fasting state and time of day change more than people expect

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u/step_therapy_s25 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/greta_chukwu18 points·1 year ago

Yes — same lab, same fasting state, same rough time of day, or the comparison is doing nothing.

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u/employer_carveout12 points·1 year ago

Agreed. The trend is the signal. A single value is a snapshot of one morning.

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u/greta_chukwu25 points·1 year ago

Brought the whole set to my clinician rather than one flagged value. Completely different conversation.

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u/cardio_endpoint_c16 points·1 year ago

nothing on this board interprets your results for you

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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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