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drlaurynlax · 6 years

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7 Most Important Lab Tests I Highly Recommend for You

Lab tests are significant to have informed decisions to provide the most appropriate treatment for a patient. Learn what are the most essential lab tests for you!

Everyone is into tracking nowadays!

In fact, there are approximately 10-million active FitBit users alone—and that’s not counting those of you who own Apple Watches, My Fitness Pal apps, heart rate monitors, and other logs and metrics that help you keep up with your own health and fitness.

A common question I get from both clients and other practitioners is what general lab tests I recommend for assessing a baseline for health—particularly if there are no serious health conditions to monitor.

Is it even worth it to run lab tests?

Lab testing can get expensive and not something insurance always covers. In addition, most docs don’t run them unless some imbalance is suspected.

However, having a baseline of health can be a powerful tool in your own tool-belt for “hacking your own health” and monitoring the effects (both positive and negative) of any lifestyle change or nutrition change you make.

Here are my top 7 lab tests I most often recommend to clients who come to me wanting to feel better, improve their digestion, balance their hormones or “boost their metabolism.”

I’ve also included a little explanation as to why these can be impactful, under what circumstances I recommend running them and healthy (functional*) lab ranges markers to look for on the test.

*Functional lab ranges are a more accurate, up-to-date healthy lab range that are used to assess risk for disease before the disease develops, compared to the standard lab ranges, many of which have not changed since the 1960’s and are used to diagnose disease once it is already a disease. In layman’s terms:

Standard reference range

The range most lab reports tell you is “normal” (but may actually indicate imbalance and early disease)

Functional reference range

The ideal range you want; an accurate lab reference range before disease, imbalances or risk factors develop.

Top 7 Lab Tests:

Comprehensive Wellness Panel, including: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Fasting Glucose & Blood Sugar Profile

Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

SIBO Breath Test

Food Intolerance Test (Cyrex)

Comprehensive Stool Test

DUTCH Complete Hormone Testing

Note: Not all of these may be warranted, based on your personal symptoms and needs. However, these are the most common ones I recommend.

Lab Testing 101

1. Comprehensive Wellness Panel

This includes: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

A general blood panel is a great place to start for assessing if you have any nutritional deficiencies that we can support via nutrition, supplements and potentially gut support. If levels are off or imbalanced, it indicates to me you’re missing something in your diet, as well as potentially not absorbing your nutrients (warranting a further investigation into your gut health). Here are some of the lab ranges I am looking for:

Cholesterol

Standard reference range: Male and female: 100–199 mg/dL Functional reference ranges: Male: 150–220 mg/dL Female: 150–230 mg/dL

Folate

Standard reference range: > 3 μg/L Functional range: > 8 μg/L

Vitamin B12

Recommended: 500 pmol/L+

Vitamin D

Recommended: 50-70 ng/ml

2. Fasting Glucose & Blood Sugar Profile

This test is for the client who has blood sugar imbalances, as well as an indicator of a need for more or less carbohydrates.

And get this: you don’t have to eat Skittles or donuts to have “blood sugar imbalances.” Common signs of blood sugar imbalances include: Headaches, afternoon crashes, caffeine or sugar cravings, PMS, hormonal imbalances, mood swings, “hanger” if you don’t eat every 2-3 hours, constant thirst, fatigue most often relieved by food, and feeling wired and tired at night. If you want to know if your blood sugar levels are normal, here’s what to look for:

Glucose

Your blood sugar levels in your body (fasted). If these are elevated or suppressed, indicates you have blood sugar imbalances, and/or you are not eating the right nutrients for your body (undereating, not enough healthy fats, potential digestive issues if not absorbing nutrients properly).

Standard reference range: 65–99 mg/dL Functional (ideal) reference range: 75–85 mg/dL

Hemoglobin A1c

A diagnostic for diabetes. An elevated hemoglobin A1c reflects higher-than-normal circulating glucose levels for the preceding three months.

Standard reference range: 4.8–5.6% Functional (ideal) reference range*: 4.6–5.3%

3. Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

“Thyroid” is a buzz term in health sphere, but what does it encompass? The thyroid gland is an endocrine gland located in the front of your neck that stores and produces hormones impacting the function of virtually every organ in your body.

Thyroid hormone (T3) governs your metabolism and is associated with changes in body weight, energy levels, hormone imbalances and appetite/digestion imbalances. If your thyroid is off, you can bet your bottom dollar you’re health is off. I typically suggest lab tests like this as a baseline, but particularly find it necessary for those who come to me complaining of unexplained weight gain or weight loss/difficulty maintaining weight, fatigue and hormone imbalances.

T3 Free

Standard reference range: 2.0–4.4 pg/mL Functional reference range: 2.5–4.0 pg/mL

Reverse T3

Healthy reference range: 9.2–24.1 ng/dL

T4 Free

Standard reference range: 0.82–1.77 ng/dL Functional reference range: 1.0–1.5 ng/dL

TSH

TSH stimulates the thyroid gland to produce thyroid hormone. Critical for every function of the thyroid. Standard reference range: 0.45–4.5 µIU/mL Functional reference range: 0.5–2.0 µIU/mL

Thyroid Antibodies (If Hashimoto’s—low thyroid—is a concern)

TPO: Reference range: 0–34 IU/mL Tg: Reference range: 0–0.9 IU/mL

4. SIBO Breath Test

Small intestinal bacterial overgrowth is an underlying pathogen associated with many gut issues that don’t “seem to heal”—no matter how clean you eat or probiotics you take. As the name suggests, this is a bacterial imbalance in your gut, triggered from an overgrowth of bacteria in your colon to your upper GI.

While we all have bacteria in our guts—good and bad—this fermenting bacteria triggers a host of digestive and health imbalances including: IBS, IBD, bloating and gas, skin breakouts, allergies, low immunity, hormonal imbalances, thyroid imbalances and malabsorption. Often times we cite “leaky gut” as being the cause for digestive complications, but SIBO is a common silent culprit that often flies under the radar.

*Take Note

(Note on SIBO Testing for Clinicians: There are two types of SIBO testing: Lactulose and Glucose breath testing, but both monitor the methane and hydrogen levels of the gut. Hydrogen based SIBO triggers more bloating and gas after meals. Methane-based is frequently associated with more loose stools and IBS like symptoms down the line. Many people take this test and only look at the hydrogen levels or treat SIBO based solely on its presence in the upper GI (and bloating), and thus, miss out on the diagnosis of the disease. You want to look at both the hydrogen and methane results, and also recognize, due to the length of testing, there are often false negatives and false positives reported (since the test cannot assess the entire 12+ hour length of your digestive process for the full picture).

If digestive symptoms continue to persist, it is often recommended to begin an “anti-microbial” treatment (kills bad bacteria), coupled with a basic paleo diet (including some carbs and starches, like fruit and sweet potatoes/potatoes, jasmine rice) with the supplements).

What to look for:

A high spike in the hydrogen over 20 ppm at any point in the test, and/or a spike in methane levels over 12 parts per million (or even over 3 ppm according to some criteria).

5. Food Intolerance Test (Cyrex)

Food sensitivities indicate gut imbalances, as well as can be highly informative to explain certain health conditions you may have—based solely on foods you eat that don’t sit well with you.

There are multiple panels you can run and I prefer to use Cyrex, based solely on the research and science backed by this testing, as well as the fact that the test assesses tolerance to foods in their most-consumed forms (raw or cooked).

Most food intolerance tests only test foods in raw form—not accounting for the fact that cooking foods changes the chemical makeup (and our tolerance or intolerance) to foods. I will most often run the Gluten (Cyrex Array 3), Gluten-Cross Reactive (Cyrex Array 4) and Total Food Sensitivity Panel (Cyrex Array 10), depending on the client’s symptoms.

6. Comprehensive Stool Test

This guy picked lingering parasistes and gut flora imbalances. I run a three-time sample to get a clear picture of any missing links. All ya gotta do? Just go. Parasites, fungal species and absorption dysfunction can all be indicated with the results from this test. This gives me a better idea as to why your “clean eating” is not helping or health conditions persist.

7. DUTCH Hormone Panel.

A urine sample assessing your estrogen, progesterone, testosterone and cortisol levels. This test takes a total of 4 samples in a day to get a clear picture of hormonal balance and levels throughout the day (as opposed to a blood sample that is just one shot in time). In addition, I will sometimes run the DUTCH 28-Day Cycle Mapping test if hormone imbalances or irregular periods/missing periods are indicated to see what your cycle is doing throughout an entire month in order to best support your nutritional needs. Lab tests like this one is very helpful.

Get it? Got it? Good!

If your doc won’t run these lab tests for you, consider working with Dr. Lauryn, OTD, NTP in her Austin clinic. You can also visit her virtual clinic to take back your health. Start today and become the best version of you, from the inside out.

The post 7 Most Important Lab Tests I Highly Recommend for You appeared first on Meet Dr. Lauryn.

Source/Repost=> https://drlauryn.com/wellness-knowledge/7-most-important-lab-tests/ ** Dr. Lauryn Lax __Nutrition. Therapy. Functional Medicine ** https://drlauryn.com/

#Holistic #Nutrition #Therapy #Recovery #Functional #Medicine #Dr. Lauryn Lax #Dr.Lauryn

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therealdiligent · 5 years

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Chapter 1: “Lost Ones”

There is no other way to say all this but to just do it in chapters cause like many of us it really feels like things have been just pouring down on us, blow after blow these days. There has been so much going on that I feel it will also be easier to end each story or use a “to be continue” when moving forward with sharing, as things did run into each other, piled on, and some are not done yet.

The end of 2019 and first few of months of 2020 have been rather bumpy to say the least.

I do want to let you know that it’s all seasons though, and as they come, they also go. And throughout it our faith has been tested and forged. But know that the light is always real and there- at the end of the tunnel and each chapter, and that light, if i’ve not made it clear with my living and sharing is........ Jesus.

Let’s call this first Chapter:

“Lost Ones”

November 2019 I go in to see my kidney doctor for a routine appointment to go over my blood pressure and kidney health. This is the doctor that over the past 2 years had been helping me with the effects of my bad management of my type one diabetes. Was assigned to him cause of some swelling in my feet and legs back in January 2017.

He had been mentioning dialysis from the beginning and for a while but during these almost 3 years, Harelyn and I had changed up our nutrition so much so that I was feeling better and the symptoms that brought us to Him in the first place weren’t there. So here we are thinking everything is gucci! And we were in one way reversing things.

See when we would come see Him he would share numbers concerning my kidney function and let me know that I had to do better but to me they where just numbers. Plus I was feeling 100% compared to when i first saw Him and not symptomatic. But this visit was different....

He shares: “Jeancarlo your creatinine level is at 4.0″, so my reaction to this info was pretty much the same, “Again with the numbers!”, but it didn't register until he used the words “ STAGE 4 KIDNEY FAILURE & END STAGE KIDNEY FAILURE.”

We finally arrived and were on the same page. The seriousness and weight of it all finally landed and hit home. It wasn’t that we were ignoring it, cause we were eating kidney friendly, low sodium meals, on top of our low carb diet to continue with my diabetes care.

See the damage was done, the past 5 years of great management did not hold up against 13 years of bad choices and bad management, this is what got the best of them.

“Lost Ones”

So here He comes again with the dialysis talk, and i'm like there’s gotta be something else doc, cause i am feeling fine and i am working with no issues, i was not at the symptomatic point of the need to go on dialysis. He went on as to why I should, I honestly was just getting lost in His words, blurred concepts, as His voice muffled and continued to fade i snapped and was like “Doc, WAIT! Is there nothing we can do to preemptively fix this!?” He pauses for a moment and then says, “Well, there is also a Kidney Transplant.” I thought to myself after and as i've shared this with people, like “MY GUY!!!! Why in the world would you not start with that instead of Dialysis!”

So, boom! Harelyn and I start doing our research, the Dr. sets up my appointments with the Transplant Team to get Hip and start into what this process looks like.

March is Kidney month and if you are not aware 1 in 3 Adults thats approx. 80 Million people are at risk of CKD (Chronic Kidney Disease). 93K people are on the Kidney transplant waiting list. It takes between 5-7 Years if you are waiting on the list and don’t have a living donor. Those stats are for a deceased kidney. A living kidney donor’s wait time is drastically shorter and is dependant on different variables, but we are talking months compared to years.

So we are in prayer and trusting for miracle in whichever way God chooses to bring this Organ cause the odds had stacked up against us once again.

We share the info with our parents and sibs and consider the risks and all the factors that come with a living donor and recipient scenario.

Its now January 2020 and some Living donors had stepped forward but no blood match had been found yet. Im still working and im feeling alright, until i start getting some back pain and swelling in my legs again.

I go in to the ER and get admitted as they consider my blood work, numbers, and options to treat. I am still trying to avoid dialysis like the plague, because i've seen the toll it takes on people and how withered away they seem after.

(See Chapter 1.5 “God Move” for details of those humbling crazy nights at the hospital)

After a few days in there and prayers we’ve come to the understanding that its best to start dialysis while not symptomatic rather than in an emergency situation. To start it I would need to go through a small procedure and get these ports put in near my neck for the dialysis treatments.

This is all temporary in our minds cause we have several living donors that are willing to gift us such an amazing gift, and some of them were pretty far ahead in their evaluation process. Also, we hadn’t gone public with the need either, so we had all these plans to start a campaign to extend the search for a Kidney. So we felt ok with starting, its been just over a month now since ive been on it. (but wait... keep reading)

So just so we are all caught up: Pause

November we Hit some critical numbers with the kidney failure and January we start the search for a living donor, and also are now considering starting dialysis temporarily given that we know for sure that there are Living Donors, and will potentially have more once we go public with things.

OK let’s continue: Play

Ports are installed for dialysis and i am getting prepped to go in to my first session. Leading up to this there have been so many conversations of faith, words of encouragement shared, tears shed, doubts crushed, sight refocused, and we were ready, I was ready.

The nurse finishes up connecting me to the most scary looking machine i've ever seen, she leans in and turns it on.

At this point all i see is my blood pumping and flowing down one tube, entering the machine and returning on the other tube back into me. I just closed my eyes and took a breath, remembered the peace that only God can provide and exhaled. Then this happened!:

5 MINUTES INTO MY FIRST SESSION

I look over to my left and there is my wife with this look on her face and she says to me:

WE FOUND A DONOR WHO IS A MATCH!

I dont think ill ever know how to express with words the flood of emotion that took over me and the feeling of gratitude in that moment.

It felt like a cheesy hallmark/lifetime movie. Super dramatic, but clutch. God was moving pieces around without us knowing and in a matter of months i found a donor. We still asked those who started the process to finish just in case, and if you are willing and would like to potentially join us in our health journey in this manner, we would love to talk and would be grateful as well.

Now things have gotten complicated because of this COVID19 business. Scheduling the transplant and any other procedures right now is tough. But we’re trusting and confident that all will work its way as we get closer.

We are floored and honored that God would use our family to show off His power, love, care, goodness, control, and best for us and all those that will know, hear, and read of our journey.

Stay tuned....

#medicine #kidney transplant #living donor #dialysis #temporary #faith #jesus #jesusisking

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heleftnowwhat · 5 years

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I haven’t written in a while. I have had some repeat doggy clients so I wanted to wait for a new one to write about.

OMG, I just had a my tiniest guest today. Diego is a 10 week old, 3lb Beagle/Chihuahua mix. This was his first visit and he did very well. I assumed that he would play for an hour and sleep for an hour and I was correct. I took him out every 60-90 mins to go potty, which he did. All and all, a great first visit. I believe that he will be coming back, YAY!!

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Like I said, I have had some repeat clients….here they are…

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Also, A friend and I went back to PA for a weekend in Sept. We joined my sister’s team, to walk and to raise money and awareness of Melanoma. It was fun and very successful. I am excited to say that my sister has had her 12th and final treatment and all looks good now. She is so strong. This is her story…..

My Melanoma Madness Family history: none Number of full skin checks I had through my life: zero Melanoma type: Acral Lentiginous (subungual) the most common in Asian, Hispanic and African American races. Of which I am not. This type of melanoma makes up less than 5% of all melanomas. Melanoma is the deadliest form of skin cancer. Timeline: Years and years ago I got a mole on the cuticle line of my left big toe. It was fine. Appeared normal. I thought it odd to get a mole on my toe, but I was not concerned. Fast forward to sometime in late 2017-ish I notice I have what I think is a blood blister. It’s near or on or around the “mole”. So I google blood blister on toe. Because who googles toe cancer??? I go several months until having it looked at.

May 2018: I’m in my 3 month diabetes check appointment with my Doc and at the end of appointment, I ask him to look at my toe. He glances at it and tells me it’s ugly and I should cover it for a week and if it doesn’t improve I should go see a podiatrist. Ok!!! Sounds easy. So I do what he tells me and it seems to start to dry up so I don’t go to the podiatrist.

September 17th 2018: Ok, I give!!! Made an appointment with the podiatrist because it seemed to get worse again. I go in, sit down and show him my “blood blister”. Instantly he tells me it is a wart. Oh! I ask if warts oozed and bled. He shook his head and told me no and that he wanted to biopsy it to see what kind of wart it was so he knew what type of antibiotic he may need to prescribe. OUCH. That kind of hurt. But ok! The results will be in in 7-10 days. Thanks doc. So, because I’m impatient, I go buy a wart freezing kit and try to freeze the little bitch off. HOLY CRAP. OUCH IS AN UNDERSTATEMENT. And it obviously wasn’t even worth the pain. Tic tock…. tic tock September 28th (10 business days later): I call the office to ask about results. I am told there are none. Sometimes these things could take up to a month they say. Of course, I argued that and said that the doctor told me 7 to 10 business days. They shrug and say they hope it’ll be in next week. HOPE?????? Mind you, I struggle with anxiety and unknown things are huge a trigger for me. Ok. Sigh.

October 5th 2018: Ring ring. Hi, this is Stephanie Heart. Calling to see if results are in. Nope. What the hell????? Ok. This is science. Deep breaths. October 17th 2018: Cell phone rings. I’m in middle of something and can’t answer my phone. Voice mail says: “ hello this message is for Dr. B…, this is so-and-so from the pathology lab in Maryland and I need to speak with you directly about one of your patient’s biopsies” UMMMMM….. what the hell? Now I’m freaked out. So of course I call back and leave a message. No response. Text— no response. Call doctors office and leave urgent message with answering service. Call doctors office again first thing in morning and start pushing. Hard. Turns out the initial abnormal results were in a couple weeks ago and lab was doing further testing. WHICH NOONE INFORMED ME OF. The lab certainly broke some rules by accidentally calling me directly. They say they will have doctor call me. 15 min later he does. Tells me same story. Says he is trying to get in touch with pathology lab and will get the results for me and I can pick them up in office tomorrow. Ok. Fine. Instantly google cancer on toe, because why else would a lab be trying to reach the doc?

October 18th (my cancerversary, I guess) I arrive at the office and go to desk and say I’m here to see the doctor about my results. They tell me he gave us this for you and hand me a sealed envelope. Um. Alright. I leave office and am in lobby. Remember, I’m impatient. So I open envelope while alone in the lobby. And all I see is MALIGNANT MELANOMA and I am alone. Frozen. Oh. Also a note with a referral to a dermatologist. That bastard let me read that alone. Ok. Now it’s a search and destroy mission. I immediately call this dermatologist and fax over results while I am on the phone. While scheduling the appointment with the receptionist, she asked me to hold on and out of nowhere this doctor gets on the phone. He tells me that he would gladly see me, however, he would be telling me immediately to get to a surgeon at Fox Chase Cancer Center and gave me the name. He told me that this was a deep tumor and it would have to be removed. Holy shit. This is serious. Like WAY serious. My fingers instantly started dialing the number to the doctor he referred me to. They were amazing on the phone while I cried and they got me set up for an appointment with the chief of surgery in less than a week. Begin massive anxiety attacks. Google. Bing. Explorer. Knowledge is power.

October 25th, 2018 Appointment with surgeon. The guy who saved my life. Tells me that the depth on the report puts me at a stage 2. Which means they remove it and then do a sentinel lymph node biopsy to check the nearest lymph node to see if it spread. But only 20% chance it would have. And then he tells me that to remove it, they have to amputate the top half of my big toe. Wait. WHAT??? Alligator tears begin flowing. Sends me on my way to schedule surgery.

November 2, 2018 Surgery day. Maybe after today I won’t have cancer anymore. Ativan on board I head to the hospital with my army. Long day of waiting and tests. Blood work. They do the injection for sentinel lymph node biopsy. Waiting and scans. Then it’s time to head back. I don’t remember any of it. Wake up. Foot is wrapped and I have a nerve block. They said they were sure they got clean margins. So as long as lymph node comes back clean, I would be cancer free! Remember only 20% chance of the lymph node being malignant. They send me home same day with healing instructions and tell me results will be in in 7-10 days. I’ve heard this before. Anxiety is in high overdrive. My family and friends took amazing care of me. But in the midst of this I told the boyfriend to take a hike. Zero empathy and he couldnt understand my fuss. It was only a toe. Not even a whole toe. It wasn’t like it was a boob or a lung. I’m sorry…. you’re out of my circle now. Piss off.

1 week later: Still no results. Tic tock. All I can think of is just getting back to work and I did. I work from home so was able to do some work and elevate.

About 12 days post op: Guess who is in the 20%???? Of course I am. Worst news I could have gotten. I now have stage 3 melanoma. Stage 3. Are you kidding me? You have to be. Now what? Time to have a PET scan of my entire body to see if it has spread anywhere. This would place me at stage 4. Thank goodness, it had not spread. I remain stage 3, but now I have to face a year of immunotherapy treatment with CT scans, skin checks, MRIs, ultrasounds and a slew of other tests every 3 months or so.

November 28 First meeting with medical oncologist. He details the plan of action to do everything we can to make sure the beast stays away. Melanoma is really sneaky and can just show up anytime anywhere. Sigh. A lifetime of anxiety. There is no cure. We set up the treatment plan.

December 5,2018 Treatment day. Lab work first to see if my body can handle it. Meet with oncologist again. Then head to the infusion room. Walk in and there are a ton of cancer patients in their chairs hooked up to IVs. Not gonna lie. It was scary and I couldn’t believe I was there. They begin the infusion after mixing the medicine. They have to wait for doc approval for this as they bill my insurance company $115,000 a month for this drug. Yes, the comma is in the right place. Infusion begins. And ends just as fast. Only about 30 min. And they send me home. Almost instantly, my entire body is hot and so itchy. A normal side effect. Any type of “itis” is. I’ll take that over chemo though. The itch continued for 2 months. My first 2 treatments.

Wash rinse repeat. I just completed my 6th of 12 treatments. I’ve had some scans and skin checks in between. So far…. I am FREE of cancer. We call this NED. No evidence of disease. And we celebrate this.

A few things I have learned: Not all melanoma comes from the sun, but most does. Mine didn’t. I am now susceptible to any and all skin cancers as well as having an increased risk of developing other types. I must be diligent with protecting myself from the sun. When in doubt, get it checked. Schedule yearly dermatology appointments. ADVOCATE for yourself for fast treatment and diagnosis. You are never too busy to take care of your health. In times of crisis you really learn who your true circle of people are. Mine is huge and I am truly blessed.

I am so thankful for the care I have received and continue to receive from everyone at Fox Chase Cancer Center. They literally have saved my life.

I still struggle with anxiety and depression and some pain and swelling. But I’m managing it by staying informed and positive and laughing at things. That’s how I deal. Gotta laugh. My side effects haven’t been horrible from treatment. I hope that my story can help at least one person to get help if needed. Early detection is KEY to surviving melanoma.

I am a melanoma warrior. A survivor. And I plan on keeping it that way.

GET CHECKED PEOPLE!!!

Doggy Guest #30 Diego and more I haven't written in a while. I have had some repeat doggy clients so I wanted to wait for a new one to write about.

#Acral Lentiginous (subungual)#cancer #dogboarding #doggydaycare #dogs #dogsitting #LynnesDoggyBnB #Melanoma

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brian-cdates · 6 years

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7 Most Important Lab Tests I Highly Recommend for You

Lab tests are significant to have informed decisions to provide the most appropriate treatment for a patient. Learn what are the most essential lab tests for you!

Everyone is into tracking nowadays!

Is it even worth it to run lab tests?

Lab testing can get expensive and not something insurance always covers. In addition, most docs don’t run them unless some imbalance is suspected.

Here are my top 7 lab tests I most often recommend to clients who come to me wanting to feel better, improve their digestion, balance their hormones or “boost their metabolism.”

I’ve also included a little explanation as to why these can be impactful, under what circumstances I recommend running them and healthy (functional*) lab ranges markers to look for on the test.

Standard reference range

The range most lab reports tell you is “normal” (but may actually indicate imbalance and early disease)

Functional reference range

The ideal range you want; an accurate lab reference range before disease, imbalances or risk factors develop.

Top 7 Lab Tests:

Comprehensive Wellness Panel, including: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Fasting Glucose & Blood Sugar Profile

Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

SIBO Breath Test

Food Intolerance Test (Cyrex)

Comprehensive Stool Test

DUTCH Complete Hormone Testing

Note: Not all of these may be warranted, based on your personal symptoms and needs. However, these are the most common ones I recommend.

Lab Testing 101

1. Comprehensive Wellness Panel

This includes: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Cholesterol

Standard reference range: Male and female: 100–199 mg/dL Functional reference ranges: Male: 150–220 mg/dL Female: 150–230 mg/dL

Folate

Standard reference range: > 3 μg/L Functional range: > 8 μg/L

Vitamin B12

Recommended: 500 pmol/L+

Vitamin D

Recommended: 50-70 ng/ml

2. Fasting Glucose & Blood Sugar Profile

This test is for the client who has blood sugar imbalances, as well as an indicator of a need for more or less carbohydrates.

Glucose

Standard reference range: 65–99 mg/dL Functional (ideal) reference range: 75–85 mg/dL

Hemoglobin A1c

A diagnostic for diabetes. An elevated hemoglobin A1c reflects higher-than-normal circulating glucose levels for the preceding three months.

Standard reference range: 4.8–5.6% Functional (ideal) reference range*: 4.6–5.3%

3. Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

T3 Free

Standard reference range: 2.0–4.4 pg/mL Functional reference range: 2.5–4.0 pg/mL

Reverse T3

Healthy reference range: 9.2–24.1 ng/dL

T4 Free

Standard reference range: 0.82–1.77 ng/dL Functional reference range: 1.0–1.5 ng/dL

TSH

TSH stimulates the thyroid gland to produce thyroid hormone. Critical for every function of the thyroid. Standard reference range: 0.45–4.5 µIU/mL Functional reference range: 0.5–2.0 µIU/mL

Thyroid Antibodies (If Hashimoto’s—low thyroid—is a concern)

TPO: Reference range: 0–34 IU/mL Tg: Reference range: 0–0.9 IU/mL

4. SIBO Breath Test

*Take Note

What to look for:

A high spike in the hydrogen over 20 ppm at any point in the test, and/or a spike in methane levels over 12 parts per million (or even over 3 ppm according to some criteria).

5. Food Intolerance Test (Cyrex)

Food sensitivities indicate gut imbalances, as well as can be highly informative to explain certain health conditions you may have—based solely on foods you eat that don’t sit well with you.

6. Comprehensive Stool Test

7. DUTCH Hormone Panel.

Get it? Got it? Good!

The post 7 Most Important Lab Tests I Highly Recommend for You appeared first on Meet Dr. Lauryn.

Source/Repost=> https://drlauryn.com/wellness-knowledge/7-most-important-lab-tests/ ** Dr. Lauryn Lax __Nutrition. Therapy. Functional Medicine ** https://drlauryn.com/ 7 Most Important Lab Tests I Highly Recommend for You via http://drlaurynlax.tumblr.com/

#Brian C. Dates #BrianDates #Holistic #Nutrition #Therapy #Recovery #Functional #Medicine

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elizabethbgrimes · 6 years

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7 Most Important Lab Tests I Highly Recommend for You

Lab tests are significant to have informed decisions to provide the most appropriate treatment for a patient. Learn what are the most essential lab tests for you!

Everyone is into tracking nowadays!

Is it even worth it to run lab tests?

Lab testing can get expensive and not something insurance always covers. In addition, most docs don’t run them unless some imbalance is suspected.

Here are my top 7 lab tests I most often recommend to clients who come to me wanting to feel better, improve their digestion, balance their hormones or “boost their metabolism.”

I’ve also included a little explanation as to why these can be impactful, under what circumstances I recommend running them and healthy (functional*) lab ranges markers to look for on the test.

Standard reference range

The range most lab reports tell you is “normal” (but may actually indicate imbalance and early disease)

Functional reference range

The ideal range you want; an accurate lab reference range before disease, imbalances or risk factors develop.

Top 7 Lab Tests:

Comprehensive Wellness Panel, including: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Fasting Glucose & Blood Sugar Profile

Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

SIBO Breath Test

Food Intolerance Test (Cyrex)

Comprehensive Stool Test

DUTCH Complete Hormone Testing

Note: Not all of these may be warranted, based on your personal symptoms and needs. However, these are the most common ones I recommend.

Lab Testing 101

1. Comprehensive Wellness Panel

This includes: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Cholesterol

Standard reference range: Male and female: 100–199 mg/dL Functional reference ranges: Male: 150–220 mg/dL Female: 150–230 mg/dL

Folate

Standard reference range: > 3 μg/L Functional range: > 8 μg/L

Vitamin B12

Recommended: 500 pmol/L+

Vitamin D

Recommended: 50-70 ng/ml

2. Fasting Glucose & Blood Sugar Profile

This test is for the client who has blood sugar imbalances, as well as an indicator of a need for more or less carbohydrates.

Glucose

Standard reference range: 65–99 mg/dL Functional (ideal) reference range: 75–85 mg/dL

Hemoglobin A1c

A diagnostic for diabetes. An elevated hemoglobin A1c reflects higher-than-normal circulating glucose levels for the preceding three months.

Standard reference range: 4.8–5.6% Functional (ideal) reference range*: 4.6–5.3%

3. Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

T3 Free

Standard reference range: 2.0–4.4 pg/mL Functional reference range: 2.5–4.0 pg/mL

Reverse T3

Healthy reference range: 9.2–24.1 ng/dL

T4 Free

Standard reference range: 0.82–1.77 ng/dL Functional reference range: 1.0–1.5 ng/dL

TSH

TSH stimulates the thyroid gland to produce thyroid hormone. Critical for every function of the thyroid. Standard reference range: 0.45–4.5 µIU/mL Functional reference range: 0.5–2.0 µIU/mL

Thyroid Antibodies (If Hashimoto’s—low thyroid—is a concern)

TPO: Reference range: 0–34 IU/mL Tg: Reference range: 0–0.9 IU/mL

4. SIBO Breath Test

*Take Note

What to look for:

A high spike in the hydrogen over 20 ppm at any point in the test, and/or a spike in methane levels over 12 parts per million (or even over 3 ppm according to some criteria).

5. Food Intolerance Test (Cyrex)

Food sensitivities indicate gut imbalances, as well as can be highly informative to explain certain health conditions you may have—based solely on foods you eat that don’t sit well with you.

6. Comprehensive Stool Test

7. DUTCH Hormone Panel.

Get it? Got it? Good!

The post 7 Most Important Lab Tests I Highly Recommend for You appeared first on Meet Dr. Lauryn.

#Elizabeth B. Grimes #ElizabethGrimes #Holistic #Nutrition #Therapy #Recovery #Functional #Medicine

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clarencebfaber · 6 years

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7 Most Important Lab Tests I Highly Recommend for You

Lab tests are significant to have informed decisions to provide the most appropriate treatment for a patient. Learn what are the most essential lab tests for you!

Everyone is into tracking nowadays!

Is it even worth it to run lab tests?

Lab testing can get expensive and not something insurance always covers. In addition, most docs don’t run them unless some imbalance is suspected.

Here are my top 7 lab tests I most often recommend to clients who come to me wanting to feel better, improve their digestion, balance their hormones or “boost their metabolism.”

I’ve also included a little explanation as to why these can be impactful, under what circumstances I recommend running them and healthy (functional*) lab ranges markers to look for on the test.

Standard reference range

The range most lab reports tell you is “normal” (but may actually indicate imbalance and early disease)

Functional reference range

The ideal range you want; an accurate lab reference range before disease, imbalances or risk factors develop.

Top 7 Lab Tests:

Comprehensive Wellness Panel, including: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Fasting Glucose & Blood Sugar Profile

Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

SIBO Breath Test

Food Intolerance Test (Cyrex)

Comprehensive Stool Test

DUTCH Complete Hormone Testing

Note: Not all of these may be warranted, based on your personal symptoms and needs. However, these are the most common ones I recommend.

Lab Testing 101

1. Comprehensive Wellness Panel

This includes: Vitamin D, Total Cholesterol, Complete Blood Count, Vitamin B12 & Folate

Cholesterol

Standard reference range: Male and female: 100–199 mg/dL Functional reference ranges: Male: 150–220 mg/dL Female: 150–230 mg/dL

Folate

Standard reference range: > 3 μg/L Functional range: > 8 μg/L

Vitamin B12

Recommended: 500 pmol/L+

Vitamin D

Recommended: 50-70 ng/ml

2. Fasting Glucose & Blood Sugar Profile

This test is for the client who has blood sugar imbalances, as well as an indicator of a need for more or less carbohydrates.

Glucose

Standard reference range: 65–99 mg/dL Functional (ideal) reference range: 75–85 mg/dL

Hemoglobin A1c

A diagnostic for diabetes. An elevated hemoglobin A1c reflects higher-than-normal circulating glucose levels for the preceding three months.

Standard reference range: 4.8–5.6% Functional (ideal) reference range*: 4.6–5.3%

3. Comprehensive Thyroid Panel (TSH, T3, Reverse T3, T4)

T3 Free

Standard reference range: 2.0–4.4 pg/mL Functional reference range: 2.5–4.0 pg/mL

Reverse T3

Healthy reference range: 9.2–24.1 ng/dL

T4 Free

Standard reference range: 0.82–1.77 ng/dL Functional reference range: 1.0–1.5 ng/dL

TSH

TSH stimulates the thyroid gland to produce thyroid hormone. Critical for every function of the thyroid. Standard reference range: 0.45–4.5 µIU/mL Functional reference range: 0.5–2.0 µIU/mL

Thyroid Antibodies (If Hashimoto’s—low thyroid—is a concern)

TPO: Reference range: 0–34 IU/mL Tg: Reference range: 0–0.9 IU/mL

4. SIBO Breath Test

*Take Note

What to look for:

A high spike in the hydrogen over 20 ppm at any point in the test, and/or a spike in methane levels over 12 parts per million (or even over 3 ppm according to some criteria).

5. Food Intolerance Test (Cyrex)

Food sensitivities indicate gut imbalances, as well as can be highly informative to explain certain health conditions you may have—based solely on foods you eat that don’t sit well with you.

6. Comprehensive Stool Test

7. DUTCH Hormone Panel.

Get it? Got it? Good!

The post 7 Most Important Lab Tests I Highly Recommend for You appeared first on Meet Dr. Lauryn.

Source/Repost=> https://drlauryn.com/wellness-knowledge/7-most-important-lab-tests/ ** Dr. Lauryn Lax __Nutrition. Therapy. Functional Medicine ** https://drlauryn.com/

7 Most Important Lab Tests I Highly Recommend for You via https://drlaurynlax.weebly.com/

#Clarence B. Faber #ClarenceFaber #Holistic #Nutrition #Therapy #Recovery #Functional #Medicine

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type2diabetestreatments-blog · 8 years

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Ask D'Mine: What Metformin Is Good For (and Not)

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Ask D'Mine: What Metformin Is Good For (and Not)

Need help navigating life with diabetes? You can always Ask D'Mine!

Welcome again to our weekly Q&A column, hosted by veteran type 1, diabetes author and clinical expert Wil Dubois. This week, Wil offers some (non-doctor) thoughts on mixing and matching your diabetes meds... particularly, metformin. This isn't a foreign concept, as we regularly receive questions about this particular medication, and Wil does his best to answer them all!

Got your own questions? Email us at [email protected]

Susan, type 1 from Georgia, writes: I have been a type 1 for 28 years and also have PCOS. I have started perimenopause and my morning blood sugar reading can suddenly jump to 400!!! Many years ago I was given metformin for my PCOS and also to help with the diabetes, I am wondering whether you feel this might help again??

Wil@Ask D’Mine answers: Four hundred is only a good number when we are talking one hundred dollar bills or bottles of wine in the cellar, not blood sugar, so ya gotta do something—that’s for sure. For other readers’ benefit, let me quickly mention that the type 2 diabetes starter drug metformin has been used for years off-label to treat polycystic ovarian syndrome (PCOS), although its use is becoming increasingly controversial. In theory, it helps by improving insulin sensitivity, as insulin resistance is part of the pathogenesis of PCOS. And, as many surprised ladies with diabetes have discovered over the years, metformin can increase fertility, which is also an issue with PCOS.

But to your question: Would it help? Sure. At least for the blood sugar. Even though it's also off-label for type 1s, metformin will still have some positive effect on us. It’s a mild insulin sensitizer after all, and it keeps the liver from dumping excess glucose into the bloodstream overnight.

Of course, you’ll still need your insulin. And lucky thing, too, as blood sugars of 400 are well beyond the power of metformin to control by itself (nevermind for the moment that a type 1 can’t use met monotherapy). Yep, when it comes to glucose-lowering power, metformin is a most excellent tool for putting out diabetes brush fires. But your morning sugars are a full-blown forest fire. You need slurry bombers, guys with shovels and chain saws, and lots of fire trucks full of water.

Will the metformin help with the perimenopause itself? Its symptoms? I doubt it. I can’t see, pathologically, how it could, and I can’t find any research on it whatsoever—although there’s no shortage of anecdotal comments on blogs and assorted vitamin-selling commercial sites. Meanwhile, there’s good evidence that birth control pills are more helpful with perimenopause cramps than anything else.

What’s all this add up to? Well, you know what we’re going to say: Ask your doc if metformin is right for you. My opinion is that it will help reduce the amount you need to increase your insulin.

Goodness. That was too many double negatives for this hour of the morning, wasn’t it?

Here’s the bottom line: Your body is changing. The shifting tides of hormones are driving your sugars upwards. As a type 1, you need to counter that with more insulin. Nothing else will do the job. Adding met will likely help the insulin work a little bit better, so you won’t have to increase the insulin as much as you would have to if you didn’t start the met. But is it worth it?

I can’t say. I don’t think it will make all that much of a difference, but I could be wrong. Everyone’s diabetes is different. But given met’s overall positive safety profile, I see no harm in trying it out.

However, if you do, I have one final word of caution before I let you go this morning. As you are starting perimenopause, your baby factory is starting to shut down. But don’t count it out just yet. Unless you want a late-life family add-on, you’ll need to use some contraception counter-measures.

As noted, Metformin is also used off-label as a fertility drug.

John, type 2 from Oregon, writes: Hello, I have type 2 diabetes. It is well controlled with A1C numbers 5.9 and lower. I would like to get off metformin or at least cut dosage in half. I bike ride almost every day. I ride about 16 miles daily, which takes about 60 minutes. My question is, would I have better blood sugar control if I did two 30-minute bike rides spaced out in the morning and evening as opposed to one 60-min bike ride daily?

Wil@Ask D’Mine answers: Seriously? Sixteen miles a day? Holy cow, I can’t even imagine. But good for you! And I see you’ve been rewarded for your efforts with an amazing A1C.

Most of the research I’ve seen on exercise indicates that numerous small bursts of activity are just as good as one big workout. Reverse correlating that, I think we can safely say that two shorter rides will have no benefit over one longer one.

Sorry.

But really, how much better do you want your control to be? Your control is admirable, to say the least. An A1C that low tells me that your diabetes is as tame as a drunken kitten that’s passed out after slurping up spilled tequila from the barroom floor. You’ve got a system in place that’s working. Why on earth would you want to screw with that? After all, metformin is possibly the safest drug on the planet.

Still, for reasons I don’t totally understand, many people like you want to use less of it (we type 1s, who need insulin just to stay alive, have a different relationship with medications). So here’s the deal: For all practical purposes, metformin doesn’t start working until you are taking 1,000 mg of it. So if you are already at 1,000 I doubt you will get away with cutting down and have it do any good. On the other hand, if you are taking 1,500 or 2,000 mg and have changed your life style since you started it, then you might be able to reduce it without waking up the kitten.

Get your doctor’s blessing first, but here’s what you need to do: Break out your meter and do a burst of intensive testing. And I don’t mean just at times of day when you know your sugar will be low. In addition to fasting tests, hit all your postprandial peaks—two hours after the first bite of each meal. Test for a week. Then take a break and go ahead and reduce your metformin. After one week on the reduced med, do a second blast of testing. Again, get a mix of fasting and post-meal readings.

Next, don’t trust your eyes. Plug the two sets of numbers into an Excel spreadsheet and see if the average has changed.

It’s a simple, safe, N of 1 clinical study that will tell you exactly how much good the met is doing you. If your sugars increase, you know that the met is an important part of your control plan, and then maybe you’ll feel better about taking it. If there’s no difference, then hell yeah, cut that baby down. It’s doing you no good!

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

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type2diabetestreatments-blog · 8 years

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Ask D'Mine: Secrets of Glucose Standards, Prepping for International Travel

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Ask D'Mine: Secrets of Glucose Standards, Prepping for International Travel

It's good to know what you don't know. Part of our mission here at our Saturday diabetes advice column, Ask D'Mine, is to peek behind the curtains of just about everything — as oftentimes conventional wisdom is not as wise as it may seem.

Well, just read today's column and you'll get the gist. Say hello to our host Wil Dubois, a veteran type 1, diabetes author and community educator who's seen it all at the clinic where he works in New Mexico.

Need help navigating life with diabetes? Email us at [email protected]

Lacey from New Jersey, type 1, asks: Where do all these target numbers we are supposed to meet come from? Who chooses our blood glucose, blood pressure, and cholesterol targets? It seems like they are always changing! Are there actually some studies to back up these numbers?

Wil@Ask D'Mine answers: Spoiler Alert: I'm here to shatter everyone's innocence. If you still want to believe in unicorns, fairies, pure unbiased medical research and the Great Pumpkin—read no further. Sorry, Virginia. There is no Diabetes Claus.

Right after your question came in, I was attending an internet seminar taught by one of the nation's leading cardiologists. I put your question to him. For reasons that will soon become clear, he asked me not to quote him by name.

All of our major targets, A1C, lipids, blood pressure, and even finger-stick meter numbers, I'm told, are not based on specific scientific studies that result in proof that these numbers are superior; but are selected by expert consensus panels. These panels issue "consensus statements" on the targets that doctors should use as treatment goals.

Quoting from the American Diabetes Association here a consensus statement "represents the panel's collective analysis, evaluation, and opinion based, in part, on the conference proceedings." (Emphasis added by me.) They go on to state, "The need for a consensus statement arises when clinicians or scientists desire guidance on a subject for which there is a relative deficiency of 'evidence' that might otherwise allow for a more definitive statement to be made."

So in other words, when there are no facts, the experts collectively make them up.

Of course, it's really not as bad as I make it sound. For instance, we know from real studies that higher blood sugar is more dangerous than lower blood sugar. And we know from real studies that very much higher blood pressure is more dangerous than lower blood pressure.

How much lower is ideal in either case, however, is rarely studied. So the experts just pick some numbers.

To clarify that this's as big pile of horse shit as it sounds like, I said to this leading cardiologist: "So what you're telling me is that a group of guys just basically sits down and uses an Ouija Board to choose our target numbers?"

He asked me to repeat my question.

Twice.

Then there was a very lonnnnnnnnnnnnnnnnnnnng silence, and then he said, "No, we use multiple Ouija boards. And we're not just any group of guys." As if to say—how could so many smart people in one room be wrong?

Learned men used to think the earth was flat. And they said men would never fly. That going into space would be impossible. The personal computer would never catch on.

Need I go on about the collective wisdom of smart men?

A couple of days later I called around and found an endo who's sat on multiple expert consensus panels. He too, asked not to be identified by name, but told me that expert panels generally consist of grey-haired white men "who sit around and pontificate all day long until 4pm. Then they realize it's time for martinis and quickly pull some numbers out of the air."

At this point I flirted with the idea of stopping all of my meds except insulin.

Dr. H. Gilbert Welch, author of Over-Diagnosed, is extremely critical of the expert consensus system, and points out that changing blood pressure targets by even 10 points nets Big Pharma millions of new customers-for-life. He also points out that the type of experts who sit on these panels are also commonly the type of experts who are compensated members of Big Pharma Speakers' Bureaus.

Not that he's suggesting any sort of conflict of interest, or anything like that.

So. Lacey. Sorry. What's a diabetic to do? May today's experts be wrong? Will tomorrow's experts look down their haughty noses at today's standards? Probably.

But it's all we've got. And we're better off today than 50 years ago. Right? We live longer. Healthier.

Looks like maybe the "experts" got a thing or two right after all. I guess I'll keep taking my meds... for now.

Ray from Texas, type 1, writes: I love flying and going on trips and never have issues. However, I have never done international travel before and I am not sure what to expect I am planning on bringing scripts, doctor's notes, BG low snacks, water, normal snacks, and extra supplies, but I am still not sure what to expect. Anything I should know about or prepare for?

Wil@Ask D'Mine answers: First and foremost, make sure you have a passport, or your trip will end at the airport. And yes. I know someone who nearly forgot her passport when leaving for an overseas journey. (And as you have never traveled overseas before, you do have a passport, don't you?)

The good news is that according to the CDC, by 2050 one out of every three TSA airport security screeners will have diabetes, making travel much easier for PWDs. Yep. Traveling with the Big-D is going to get nothing but easier!

Seriously, assuming you are not going around the world in 80 days, international travel is much like domestic travel, only with the irritation and hassles super-sized. Assuming your trip is less than a month, make sure you have enough of all of your medications and testing supplies. I'd pack all of this in my carry-on, if I were you. Ditto pump supplies, if you use a pump. In fact, I'd pack a margin of error for more of everything than you need, if I were you.

Ask your health care provider to give you paper copies of all of your medication prescriptions. This isn't for airport security but to help you attempt to secure more supplies in case, oh... I don't know... a volcano or something goes off in Iceland and you can't fly home as scheduled. A letter from your Doc summarizing your medical conditions, gear, and meds can also help smooth over any potential airport security hassles.

As for hypo snacks, I haven't been overseas for a while, but recently flew half way across the country for a conference, and packed about two dozen bottles of Dex4 fluid. I got some raised eyebrows from the security folks, but no hassles. In your case, you really just need to carry enough for the flights (which could be many hours). Once you are at your destination, discovering local high-carb snacks to treat low blood sugar is half the fun of traveling.

If you think you need water, ya gotta buy it (for only slightly less per ounce than French Perfume) inside the security gates. You won't be allowed to carry water through airport security.

And of course, always visit the TSA website shortly before your journey to double check for any changes. If Al-Qaeda puts an insulin pump bomb on a plane, train, or automobile, none of us PWDs will ever be able to travel again.

Bon Voyage!

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

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type2diabetestreatments-blog · 8 years

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Ask D'Mine: Is Medicare Snooping? And Dead CGMs

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Ask D'Mine: Is Medicare Snooping? And Dead CGMs

Who doesn't sometimes need help navigating life with diabetes? That's why we offer Ask D'Mine, our weekly advice column, hosted by veteran type 1, diabetes author and educator Wil Dubois. This week, he takes a look at the federal government's involvement in approving test strip prescriptions, and — being an expert continuous glucose monitor user and book author on the topic — Wil gives some advice on what sometimes happens when a GCM transmitter stops working. Go on, read up!

Got your own questions? Email us at [email protected]

Nancy, type 2 from Missouri, writes: When I picked up my test strips this month, my pharmacist told me that Medicare is requiring my pharmacy to have a copy of my blood sugar logs for 30 days, no more than 6 months old. An annoyance to be sure, since I tend to suck at writing them down. But, beyond that, I don't get the rationale. Is it some kind of test to prove that I use the damn strips? If so, what's stopping me from making up the numbers for a log? And it's feeling like a big fat invasion of privacy. I like my pharmacist, he's a great guy. But he doesn't make treatment decisions such as how much insulin I use or whether I'm in good enough control, so there's no reason that I can see that he needs to have my test logs. Perhaps Medicare is trying to make it annoying for me to get the strips so I'll just pay for them myself? Do you know anything about this?

Wil@Ask D'Mine answers: I checked with some folks in the Medicare supply biz, and they tell me that Medicare only requires the 30 days of less-than-half-year-old data when a patient uses more strips than Medicare likes to pay for. As a reminder to everyone, Medicare guidelines only cover one strip per day for folks on pills and three per day for insulin shooters. Not enough in either case.

Of course, your doc can fill out the paperwork for an "over-utilization" request. If your doc has a documentable medical reason for your needing the amount of strips that any sane person would realize that any healthy diabetic would need in the first place, the feds are pretty good about covering them. Commercial insurance is another matter altogether, however. They take the fed guidelines and cast them in stone. Getting what you need from a commercial plan is a nightmare. Cost is always excessive and sometimes even then, you're screwed as they won't always listen to a physician's override prescription all in the name of "medical necessity." So much for this being between you and your doc ...

But back to your situation. Yeah, the feds do require the supplier or pharmacy to keep copies of logs or doctor's notes. It's nothing super-new; it's a small part of 2010's Improper Payments Act. And yes, it's absolutely a test to prove that you use the damn strips. An annoyance? Perhaps. But I gotta say, if Medicare is willing to give you twice or three times the number of strips that they misguidedly think you need—at no additional cost to you—I don't think it's outrageous for them to ask for occasional proof that you're actually using them.

Wow. Never thought I'd see the day I'd be defending Medicare. But will Medicare even look at your logs? Probably not. Medicare has a small SWAT team of medical reviewers that travel around the country and pounce unexpectedly on the suppliers cashing those big checks from the government. God help the pharmacy that sells you a gazillion strips, then gets raided during a random audit and can't prove that your doc ordered the strips, and that you're using them.

The feds aren't going to judge your blood sugar, they're only interested in whether or not you're actually using what they pay for. It's not about your health. It's about the money. So you aren't being judged, nor is your doctor. It's an anti-fraud kinda thing. Medicare is served by a legion of for-profit companies that get rich preying on seniors. Late night ads, aggressive phone marketing, and refill increases that neither doctors nor patients asked for or needed got us where we are today.

Now for you, Nancy, I have a few ideas. The log doesn't have to be hand-written. You can give the pharmacy a download of your meter—although I admit it is odd they asked you directly; typically they'd send a request to your doc. Anyway, if you don't know how to do a download, ask someone at your doctor's office for help. As to your privacy: yeah, the boys at the one-hour photo will absolutely look at your naked pics, and probably make copies for themselves, too. But I doubt your pharmacist is the blood sugar equivalent of a dirty old man. He'll probably put your log into a file cabinet without looking at it. Still, if you want to keep your blood sugar data more private (I understand), you can just have the statistics page for 30 days printed. The stats page gives the number of times you tested in the time period, the highest reading, the lowest reading, and the average. Is someone still peeking into your underwear drawer? Yes, but they'll be learning a lot less than they could from the full log book.

Could you forge a log? Sure. Why not? Teenagers do it every day. Usually in the waiting room at the endo's office. You could even ask for more strips, forge a bigger log book, then sell the strips on Ebay. The system isn't perfect. But the feds are more interested in keeping the suppliers honest than in keeping the patients honest.

One last thing. My friendly local EdgePark rep, one of the ones I queried about this issue, was mortified that you were turned away by your pharmacy, saying, "The pharmacy should not have refused the script, but should have at least filled the Medicare guideline amount, then required the patient to give them a log book," before filling the rest of the script.

Anyway, moving forward, I think we'll see a lot more requirements like this. Healthcare costs are out of control and there's going to be a lot of time and money wasted to ensure that we're not wasting time and money. But for me, I would have been more than happy to give my insurance company two log sheets per year to get the strips I need. I gave them a lot more than that, and was still turned down.

Allison, type 1 from Arizona, writes: OK, I need to get my Medtronic sensor going again. I have your CGM book in one hand and the little blue transmitter charger in the other. I'm trying to figure out why my charger is flashing red. I've changed the battery and even left it plugged in overnight. Suggestions?

Wil@Ask D'Mine answers: Sorry Allison, you're screwed. Red is dead. A little-known, but apparently published (in small print, in Appendix MCXII of the MiniLink user's guide) fact is that if you let your transmitter fully discharge, it's the same as drowning a baby squirrel: There's no bringing it back.

You'll have to buy a new one. If it makes you feel any better, I did the same thing to an iPro transmitter at the clinic. My boss told me if I ever did it again, it was coming out of my paycheck!

So here's the deal, boys and girls: If you're taking a CGM vacation, put a fresh copper-top into the little blue charger and leave the frickin' transmitter plugged in. If you're on a CGM vacation and didn't do this, go attend to it right now.

No more drowned baby squirrels! It's crazy because we're "trained" to worry about over-charging batteries on our devices, but not warned that apparently, keeping a trickle charge going to your Med-T transmitter is its life support system. I guess taking our squirrel analogy to its extreme, keeping the transmitter charging is needed for healthy hibernation.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

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