Vitamin/Hormone Imbalance Blood Test Question
January 31, 2010 2:17 PM Subscribe
Is there a way to get some type of comprehensive blood test (or multiple) that checks for imbalanced hormones and vitamin/mineral deficiencies? If so, how can I go about getting them done for my fiancee?
As far as vitamin/mineral deficiencies, your fiancee is out of luck.
So what, that iron test my Doctor gave me was "alternative medicine"? Wrong. Sure deficiences generally occur as part of something else (life styles or medical problems) but that doesn't make them invalid, not a real health problem, or not worth testing for and the tests most definitely do exist.
There are tests for vitamin and mineral deficiences (just like for hormonal imbalances) and those deficiences most definately do sometimes occur. Going in and getting scattershot test for everything isn't helpful though. Instead your fiance should make an appointment with he GP for a geneal checkup, talk to them about her health concerns and work out which tests are appropriate from there. This does need to be done with a proper medically-qualified Dr because quacks do sometimes push all kinds of weird deficiences/overlaods as being the root of all health problems, but again the co-opting of this area by the CAM people doens't mean genuine health problems suddenly no longer occur.
posted by shelleycat at 3:00 PM on January 31, 2010
So what, that iron test my Doctor gave me was "alternative medicine"? Wrong. Sure deficiences generally occur as part of something else (life styles or medical problems) but that doesn't make them invalid, not a real health problem, or not worth testing for and the tests most definitely do exist.
There are tests for vitamin and mineral deficiences (just like for hormonal imbalances) and those deficiences most definately do sometimes occur. Going in and getting scattershot test for everything isn't helpful though. Instead your fiance should make an appointment with he GP for a geneal checkup, talk to them about her health concerns and work out which tests are appropriate from there. This does need to be done with a proper medically-qualified Dr because quacks do sometimes push all kinds of weird deficiences/overlaods as being the root of all health problems, but again the co-opting of this area by the CAM people doens't mean genuine health problems suddenly no longer occur.
posted by shelleycat at 3:00 PM on January 31, 2010
itamin deficiencies are exceedingly rare in the first world
Umm, not vitamin D. Do a google new search, it might not be bad enough to cause rickets, but people are still suffering problems from not getting enough. Also many people don't have a high enough intake of essential fatty acids like omega-3s. The Queen of Fats by Susan Allport is a good book about this.
posted by melissam at 3:02 PM on January 31, 2010
Umm, not vitamin D. Do a google new search, it might not be bad enough to cause rickets, but people are still suffering problems from not getting enough. Also many people don't have a high enough intake of essential fatty acids like omega-3s. The Queen of Fats by Susan Allport is a good book about this.
posted by melissam at 3:02 PM on January 31, 2010
Vitamin deficiencies are exceedingly rare in the first world - to the point where treatments for most deficiencies are generally considered "alternative medicine."
What? My doctor (Kaiser Permanente — not exactly "alternative medicine") ordered blood tests for me that included my vitamin D level, at my request. When they came back, they showed a reference range of 30-130 (I forget what units), and my level as 16. "Start taking vitamin D," my doctor said. "You can get it at any pharmacy, or at Trader Joe's."
OP, is your fiancee dealing with any specific issues that are making you or her think she has a nutritional problem? I asked to have my vitamin D tested because I was feeling fatigued most of the time, and recent research has shown vitamin D to be linked with fatigue and energy level. Your fiancee would probably be best off talking with her doctor about whatever she's concerned about, and seeing what tests the doctor suggests. Or, if there are no specific concerns, just "it's been too many years since the last time I had a physical and my cholesterol and suchlike checked", that's also something to discuss with the doc.
posted by Lexica at 3:03 PM on January 31, 2010
What? My doctor (Kaiser Permanente — not exactly "alternative medicine") ordered blood tests for me that included my vitamin D level, at my request. When they came back, they showed a reference range of 30-130 (I forget what units), and my level as 16. "Start taking vitamin D," my doctor said. "You can get it at any pharmacy, or at Trader Joe's."
OP, is your fiancee dealing with any specific issues that are making you or her think she has a nutritional problem? I asked to have my vitamin D tested because I was feeling fatigued most of the time, and recent research has shown vitamin D to be linked with fatigue and energy level. Your fiancee would probably be best off talking with her doctor about whatever she's concerned about, and seeing what tests the doctor suggests. Or, if there are no specific concerns, just "it's been too many years since the last time I had a physical and my cholesterol and suchlike checked", that's also something to discuss with the doc.
posted by Lexica at 3:03 PM on January 31, 2010
Any clinical nutritionist can order comprehensive bloodwork from a reputable lab. The nutritionist in the practice I'm associated with orders labwork all the time for her patients. Often those patients come to her via referral from their MDs.
posted by headnsouth at 3:15 PM on January 31, 2010
posted by headnsouth at 3:15 PM on January 31, 2010
Response by poster:
Just looking for some input on how to properly navigate the system is all.
posted by mdpatrick at 3:25 PM on January 31, 2010
As far as vitamin/mineral deficiencies, your fiancee is out of luck. Vitamin deficiencies are exceedingly rare in the first world - to the point where treatments for most deficiencies are generally considered "alternative medicine." Nutrient deficiencies, when they occur, are usually the result of a larger medical problem.Some nutrient deficiencies are extraordinarily uncommon in the first world, while others are more common. A good example of this is Vitamin D, as well as omega-3. No self-diagnosis, I'm just looking for information on the most convenient/accurate ways to go about what we're looking for. I'm all for going the professional route... I just need to know the right professional to look for. We've had some really bad input from some of the doctors around here (including a doctor suggesting putting her on anti-depressants for "neuropathy" when she had endometriosis, and in fact suggested as much to him which he blatantly shot down).
Just looking for some input on how to properly navigate the system is all.
posted by mdpatrick at 3:25 PM on January 31, 2010
Response by poster: To be 100% accurate she hasn't been diagnosed with endometriosis yet (lab work is being done), but she's had a laprascopy and had some stuff removed. The point is, anti-depressants was a poor suggestion when her problems was a physical abnormality. This, however, is entirely beside the original point -- just wanted to clarify.
posted by mdpatrick at 3:30 PM on January 31, 2010
posted by mdpatrick at 3:30 PM on January 31, 2010
I work sometimes in a primary care clinic where occasionally people come in for a physical check up and say something along the lines of "I want the works", which usually means they want "everything" checked. Except for the obviously deranged people, the ones who want to order these tests are often usually young, fit, and healthy and not displaying any obvious signs of hormonal dysregulation or nutritional deficit.
One way of dissuading them is to show them the billing code sheet, which displays, in minute type, the code for all of the literally hundreds of tests that can be ordered. And these are just the ones common enough to warrant being printed on a handy one-page cheat sheet. For a complete workup, you could easily drain enough blood from an human adult to put them into shock.
The issue with checking tests like this is that the reference ranges are just that: ranges. They usually describe what a particular lab or study has found is a range of values appropriate to encompass two standard deviations around the median for a particular value within a particular population. This means that if you test 20 healthy people, there's a pretty good chance that one of them will have a value that is outside the reference range but there is *nothing* wrong with them. They are just an outlier. If you test 20 values in a single person, you can see that you can quickly run into a situation where you are beginning to have a very good chance of finding something "wrong" with them that does not, in fact, represent a disease or deficiency state, but simply represents normal variability. Very few treatments of procedures are without risk, and so the idea of possibly causing harm based on incidental findings without clear significance creates caution.
And your test result is also only as good as the lab analysis equipment+technician that performs the test, and the circumstances of the collection procedure. All of these are subject to error and deviations from optimal calibration.
That is why most responsible doctors are generally hesitant to order tests without clinical correlates, physical symptoms or signs, or where the consequences of missing an occult deficiency or excess of a marker are so serious that accepting the existence of false positives and false negatives is balanced by the utility of performing the screen.
posted by meehawl at 3:36 PM on January 31, 2010 [5 favorites]
One way of dissuading them is to show them the billing code sheet, which displays, in minute type, the code for all of the literally hundreds of tests that can be ordered. And these are just the ones common enough to warrant being printed on a handy one-page cheat sheet. For a complete workup, you could easily drain enough blood from an human adult to put them into shock.
The issue with checking tests like this is that the reference ranges are just that: ranges. They usually describe what a particular lab or study has found is a range of values appropriate to encompass two standard deviations around the median for a particular value within a particular population. This means that if you test 20 healthy people, there's a pretty good chance that one of them will have a value that is outside the reference range but there is *nothing* wrong with them. They are just an outlier. If you test 20 values in a single person, you can see that you can quickly run into a situation where you are beginning to have a very good chance of finding something "wrong" with them that does not, in fact, represent a disease or deficiency state, but simply represents normal variability. Very few treatments of procedures are without risk, and so the idea of possibly causing harm based on incidental findings without clear significance creates caution.
And your test result is also only as good as the lab analysis equipment+technician that performs the test, and the circumstances of the collection procedure. All of these are subject to error and deviations from optimal calibration.
That is why most responsible doctors are generally hesitant to order tests without clinical correlates, physical symptoms or signs, or where the consequences of missing an occult deficiency or excess of a marker are so serious that accepting the existence of false positives and false negatives is balanced by the utility of performing the screen.
posted by meehawl at 3:36 PM on January 31, 2010 [5 favorites]
Response by poster:
posted by mdpatrick at 4:24 PM on January 31, 2010
One way of dissuading them is to show them the billing code sheet, which displays, in minute type, the code for all of the literally hundreds of tests that can be ordered. And these are just the ones common enough to warrant being printed on a handy one-page cheat sheet. For a complete workup, you could easily drain enough blood from an human adult to put them into shock.This is some really good input on the technical barriers involved. Thank you.
posted by mdpatrick at 4:24 PM on January 31, 2010
If your fiancee has suspected endo and there's reason to believe that there are hormonal problems going on as well, a reproductive endocrine specialist would probably be able to narrow down the range of things to check on.
posted by fairytale of los angeles at 6:15 PM on January 31, 2010
posted by fairytale of los angeles at 6:15 PM on January 31, 2010
This thread is closed to new comments.
As far as vitamin/mineral deficiencies, your fiancee is out of luck. Vitamin deficiencies are exceedingly rare in the first world - to the point where treatments for most deficiencies are generally considered "alternative medicine." Nutrient deficiencies, when they occur, are usually the result of a larger medical problem.
Speaking of which, it sounds like your fiancee has an issue that she is trying to diagnose herself. Why not tell a doctor about the symptoms and let them figure it out?
posted by Willie0248 at 2:39 PM on January 31, 2010