I underwent the angst of PSA earlier this year. Physical in February, PSA came back at 13. Set up to see urologist. Antibiotics for 2 months and retest. PSA back to 3.5 where it has been for several years. 3 months later, another PSA result at 3.9. The urologist wants to continue 6 month visits. I am not going back unless I have another elevated PSA. As an engineer, I like data. So I am torn between more testing vs no testing unless there is an issue. I have learned you have to educate yourself and be your own advocate. Otherwise, you end up being the tail on Crack the Whip!
One thing you can do if you, like me, plan to continue regular blood screening is to make sure your blood draw is done at the same time of day every time- for me that's as soon as Quest opens.
Many hormones fluctuate quite a lot throughout the day. If you do your bloodwork first thing in the morning one time, and even a few hours later the next time, that alone could be a major factor for why your results have changed.
I watched a youtube by a cardiologist on heart disease screening and his main point is you are getting tested to determine if you need medication and that's about all that it does for you if you don't have symptoms. You already know you should eat a heart healthy diet, exercise, not smoke, etc so unless you are willing to add a bp med or statin there isn't any value in the testing. I think you could apply the same logic to most tests that are performed. There's not much value in a test unless the results can be used to change some behavior or medication.
not sure I'll have time to watch it all. It is one of the only screenings that they can directly see issues and correct them on the spot. It's not without risk of harm during the procedure and I don't imagien it's pleasant.
These are all wonderful comments and perspectives and we are of like mind. Doing a test, knowing what you will do with the results is a great "mindset". I hope that the Newsletter/Podcast broadening folks' knowledge of the upsides and downsides of these blood panel/total body MRI screenings. regards, Dr. Bobby (Dubois), Live Long and Well podcast
Before ordering specific tests, screening, or otherwise, I used to only ask myself “will the result of the test change my management advice for this patient?” Now I also ask myself “Will the results of the test be a motivating force for my patient?” I agree, most people know that they should lead a healthy lifestyle to reduce their chances of developing many metabolic or age-related diseases, but we have to all acknowledge that our discipline to consistently implement this in our lives is highly variable, and sometimes seeing a result on paper is a motivating force. As a physician, my job is not to find and fix things. My job is to equip my patients with the knowledge to make well-informed decisions about their health, and this includes testing and treatment options. As a concierge physician I get to know my patients well, I understand their motivations and goals. I offer them options. I educate them on usual care guidelines and emerging expert opinions, etc. I navigate, they drive.
Really good perspectives. Never considered things like biopsies could go sideways, false positives, mental health implications of bad test results…thanks for sharing!
I had a calcium scan a couple years back. 48 yr old male now. Scored slightly above 100 (not awful but not good). Convinced me I was going to die (sooner than I’d hoped). Two years later, lots of discussion with my primary and a couple specialists (cardio includes) and I still have no idea why it was high other than “genetics.” Did all the Attia blood markers after that - nothing even slightly high (and most somewhere around what Attia would recommend). Only actionable advise so far - keep exercising (I’m very active), take a statin (knock on wood, no side effects) and a daily aspirin and keep in L-I-V-I-N. Head scratcher for sure. Maybe I’ll try the guy you mentioned! Thanks for the article.
I underwent the angst of PSA earlier this year. Physical in February, PSA came back at 13. Set up to see urologist. Antibiotics for 2 months and retest. PSA back to 3.5 where it has been for several years. 3 months later, another PSA result at 3.9. The urologist wants to continue 6 month visits. I am not going back unless I have another elevated PSA. As an engineer, I like data. So I am torn between more testing vs no testing unless there is an issue. I have learned you have to educate yourself and be your own advocate. Otherwise, you end up being the tail on Crack the Whip!
I'm an engineer too and it can be easy to obsess about the numbers, especially if you've got a nice graph.
One thing you can do if you, like me, plan to continue regular blood screening is to make sure your blood draw is done at the same time of day every time- for me that's as soon as Quest opens.
Many hormones fluctuate quite a lot throughout the day. If you do your bloodwork first thing in the morning one time, and even a few hours later the next time, that alone could be a major factor for why your results have changed.
I watched a youtube by a cardiologist on heart disease screening and his main point is you are getting tested to determine if you need medication and that's about all that it does for you if you don't have symptoms. You already know you should eat a heart healthy diet, exercise, not smoke, etc so unless you are willing to add a bp med or statin there isn't any value in the testing. I think you could apply the same logic to most tests that are performed. There's not much value in a test unless the results can be used to change some behavior or medication.
Was there any conclusion on colonoscopy? Watching the link now but it’s heavy going and doesn’t seem to be much agreement either!
not sure I'll have time to watch it all. It is one of the only screenings that they can directly see issues and correct them on the spot. It's not without risk of harm during the procedure and I don't imagien it's pleasant.
These are all wonderful comments and perspectives and we are of like mind. Doing a test, knowing what you will do with the results is a great "mindset". I hope that the Newsletter/Podcast broadening folks' knowledge of the upsides and downsides of these blood panel/total body MRI screenings. regards, Dr. Bobby (Dubois), Live Long and Well podcast
Before ordering specific tests, screening, or otherwise, I used to only ask myself “will the result of the test change my management advice for this patient?” Now I also ask myself “Will the results of the test be a motivating force for my patient?” I agree, most people know that they should lead a healthy lifestyle to reduce their chances of developing many metabolic or age-related diseases, but we have to all acknowledge that our discipline to consistently implement this in our lives is highly variable, and sometimes seeing a result on paper is a motivating force. As a physician, my job is not to find and fix things. My job is to equip my patients with the knowledge to make well-informed decisions about their health, and this includes testing and treatment options. As a concierge physician I get to know my patients well, I understand their motivations and goals. I offer them options. I educate them on usual care guidelines and emerging expert opinions, etc. I navigate, they drive.
-Dr. Sharma, President Elite Medical Associates
Really good perspectives. Never considered things like biopsies could go sideways, false positives, mental health implications of bad test results…thanks for sharing!
I had a calcium scan a couple years back. 48 yr old male now. Scored slightly above 100 (not awful but not good). Convinced me I was going to die (sooner than I’d hoped). Two years later, lots of discussion with my primary and a couple specialists (cardio includes) and I still have no idea why it was high other than “genetics.” Did all the Attia blood markers after that - nothing even slightly high (and most somewhere around what Attia would recommend). Only actionable advise so far - keep exercising (I’m very active), take a statin (knock on wood, no side effects) and a daily aspirin and keep in L-I-V-I-N. Head scratcher for sure. Maybe I’ll try the guy you mentioned! Thanks for the article.