[Discussion] can we stop arguing about lipids until somebody posts a number
Asking properly rather than in a comment on somebody else’s thread: can we stop arguing about lipids until somebody posts a number.
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.
My ApoB moved and I spent a fortnight convinced I knew why. The repeat six weeks later was back in range and I had changed nothing.
Compared two draws across two labs and spent a week worrying before finding out the assays were different.
Tell me where this is wrong. That is the useful part of posting it.
best — the order this archive was captured in
Left up. It is a question about how to compare panels, not a request for interpretation.
Draw at the same point in the week now, fasting, same lab. The noise dropped enormously once I standardised.
Disagree with reading anything into that. One value, one morning, and you changed two other things in the same window.
nothing on this board interprets your results for you
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.
The confounding problem, stated plainly, because this board keeps stepping on it.
This is the sentence to read before anybody panics about a single value.
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.
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.
Push back: a value just outside a reference interval is a common finding in healthy people. It is a reason to repeat.
What did the repeat show?
What did the repeat show?
Adding the obvious one — take it to whoever ordered the panel. This board cannot read it for you.
Adding the obvious one — take it to whoever ordered the panel.
india_generic_g is right that a reference interval is not a target. It is a description of a population.
the trend line matters more than any single value
Is that the same assay, or did the lab change platforms?
Brought the whole set to my clinician rather than one flagged value. Completely different conversation.
Yes. Repeat before you react. Almost every alarming single value I have posted here regressed on the repeat.
baseline before you start is worth more than any later panel
baseline before you start is worth more than any later panel
Disagreeing with this bit: that change is confounded by the weight loss itself and cannot be attributed.
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.
That is a non-fasting value and the interval you are comparing it against is a fasting one.
Correction: that marker is reported in different units by different labs, which explains the tenfold difference you are seeing.
lab reference ranges are not treatment targets
I would not draw a line through two points, especially when the second was taken at a different time of day.
This. Reference ranges are population intervals, not targets, and conflating them causes a lot of unnecessary alarm here.
one measurement is a point, two is a line, three is a trend
Different laboratories use different assay platforms with different calibration. Comparing across labs adds a systematic offset that is invisible on the report.
Agreed on assay changes. A lab switching platforms between your draws is invisible unless you ask.
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.
assay method matters, especially between different labs
- 1Nobody here can interpret your panel and this comment is not doing so. What…8 comments in this branch · started by u/coldchain_karen
- 2Left up. It is a question about how to compare panels, not a request for…7 comments in this branch · started by u/lipid_panel_larry