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What do you think of requiring routine mammograms when there is no history of breast cancer in the family?
Out of my expertise. Just my opinion like everybody else's but historically medical screening and treatments have been aggressive to start. The premise is that if one detects something early then the outcomes are better. Then we had aggressive treatments with regard to cancer to make sure no metastasis could present itself later on. Total mastectomies were the first option early on. The breast was removed thinking that it would metastasize to surrounding tissue or the other breast. Later on, it was postulated that the tumors were not metastatic but growths of their own. That theory allowed for lumpectomies in many cases of simply removing cancer and leaving the rest of the breast alone. I know a very young woman in her thirties that had one small lump and they took it out. They also used chemo to treat any possible other sites.
That same theory that lead to lumpectomies however meant that if there were de novo cancer growths later then what caused them? One then made reassessments of radiation effects and frequency. So we now have a balancing act with regards to exposure and the risk-benefit ratio of screening.
Right now my understanding is that they are trying to develop and explore better technology for screening. The final determinant however will be the outcome studies of doing it one way or another.
Again my information is limited so I don't claim to be on terra firma.
Medicare requires 2 appointments a year in order to receive ongoing meds (20+) years. One is blood work done a week prior. We discuss results, the actual doctor will check my heart, look in my ears oh and feel lymph nodes on neck.
The other appt is basically just talking, and get more refills on meds. Haven't had a gyno appt in many, many years. The Nurse Assistant does blood pressure, temp, 02 stats, then they ask all these questions once a year for medicare, do you feel safe? Do you feel everyone would be better is you weren't here. Blah Blah Blah
Medicare requires 2 appointments a year in order to receive ongoing meds (20+) years. One is blood work done a week prior. We discuss results, the actual doctor will check my heart, look in my ears oh and feel lymph nodes on neck.
The other appt is basically just talking, and get more refills on meds. Haven't had a gyno appt in many, many years. The Nurse Assistant does blood pressure, temp, 02 stats, then they ask all these questions once a year for medicare, do you feel safe? Do you feel everyone would be better is you weren't here. Blah Blah Blah
Hmmm.. maybe for you medicare requires 2 visits a year but we have never had 2 visits a yr. That wellness visit is not required and its nonsense in my opinion anyway. And medication renewals are every 90 days and dont require a visit to the dr. just the dr renewing the prescription.
Hmmm.. maybe for you medicare requires 2 visits a year but we have never had 2 visits a yr. That wellness visit is not required and its nonsense in my opinion anyway. And medication renewals are every 90 days and dont require a visit to the dr. just the dr renewing the prescription.
With regards to the tests mentioned. There are intricacies implied whenever screening tests are performed. Some of those might not be apparent to the PCP general practitioner. If any screening tests alert to the possibility of a disease then a specialist is brought in. This is especially true for endocrine disorders like hypothyroidism or for a nephrologist for renal disease.
When it was first mentioned that I had stage 2 the doctor said it was very mild and nothing to worry about.
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The intent of performing screening tests is to find a disease. One screens with a sensitive test in order not to miss the condition. Once you get that initial separation then one uses other tests to provide specificity. There are few tests that are 100% specific and 100% sensitive in detecting and diagnosing disease. So the strategy is to use very sensitive tests knowing that one will see false positives with sensitive screening techniques.
I'm sure a specialist would have lots of tests they want to do in the name of playing it safe. Such as an x-ray to make sure there's no malformation or a biopsy to make sure there's no cancer. And they will never tell you how many tests they have in mind to begin with. They will just roll them out gradually, one at a time. That's why I never asked for a specialist, even though I had a question about how to adjust the formula.
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With regards to vitamin D levels and the taking of vitamins in general, most studies have been retrospective studies and not interventional and when interventional studies have been undertaken they have been disappointing. One reason why they disappoint is that they don't separate deficiency states vs no deficient states. They all are simply given the vitamin without measuring anything before or after and the reason is because of the type of study that they use.
T. Colin Campbell, in his revised edition of "The China Study", said he doesn't believe in taking vitamins but for two exceptions: Vitamin D and B12. I should have mentioned that my PCP wanted me to take 50,000 IU of vitamin D and there's no way I would ever have done that because it could be toxic at that level. I took about 800 IU and brought my blood level up to 29. I've been taking a small B12 supplement for the past 16 years (160mcg.) and every time I get tested for B12 I am right in the middle of the acceptable range.
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"COMMENTARY
It's Official. Vitamins Don't Do Much for Health
Well, in the most thorough meta-analysis to date, researchers from Kaiser-Permanente crunched the numbers from virtually every randomized trial of vitamin supplements in adults to conclude that, basically, they do nothing."
I agree with that except for vitamin D and B12 because it seems to have been working well for me over the past many years.
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With the TSH, the proper course would be to have you evaluated by an endocrinologist who could assess your status. Most causes of primary hypothyroidism is an autoimmune disease that causes the production of antibodies that are tested for. Hopefully noting your eating habits and lack of antibodies would have alerted the endocrinologist. If you had come down with a primary goiter or a nodule then the pathology report would show basic hypertrophy whereas Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis would be more inflammatory.
I've been taking a liquid iodine supplement (150mcg), one drop per day, for about the past 5 years and every TSH test comes out to 4.50 and the doctor is satisfied with that. I am too.
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So in your case, you should be monitored for being a vegan. Not sure what vegans eat or don't eat if that excludes iodized salt or not or seafood.
Not only I don't eat seafood, where most dietary iodine comes from, but I don't use iodized salt. By-the-way, for some reason, doctors don't think that iodized salt is a supplement. The same goes for milk and other non-dairy alternatives that are fortified with vitamin D. Not to mention multiple vitamins in some fortified breakfast cereals.
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The eGFR is a crude test or calculation based on one number, the creatinine level. It does not take into account genetic variations and they basically broke it down into black and white populations with each having a different correction factor. When they originally came up with it it was understood that it was only a crude test and that in general, it did not work very well when the calculation was over 60 ml/min. Most places simply report greater than 60 rather than report an inaccurate number that can mislead doctors.
After saying that it is also common knowledge that low numbers below that are also inaccurate. It is a gross estimate up and down the scale. it is not the gold standard. The gold standard is an actual clearance involving an exogenous substance that isn't actively secreted. Indigenous substance clearances like creatinine are not ideal because of the things you mentioned.
Right, it's not an accurate test, and the numbers can bounce around somewhat from one test to another.. On the last test the doctor told me he thought it was acceptable. Of course I'm never satisfied because I want to learn how to improve my performance. There was a study done in Israel and it was stated that our kidneys can regenerate and often do so throughout our lives. So kidney disease can be reversed, but they didn't say how. I suppose it's up to each one of us to figure it out.
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You said that you were better off being tested while I don't see that at all. You had one false-positive test result with the eGFR. The TSH was subclinical hypothyroidism range under 10. They did a study that I have mentioned before where they took people from the general population and did TSH levels and took all the people with elevated TSH under 10 and divided them into two groups. One group they told them that they had subclinical hypothyroidism and the other half told them nothing. They asked questions about general health and quality of life questions. The people who were told had a lesser quality of life compared to the other half who said that they felt fine in comparison.
When I said "better off", I meant mostly from the standpoint of having learned a lot. For example, I read a couple of thyroid books and learned that in order for our thyroid to function properly, iodine is needed to produce Thyroxine. Otherwise, if it had not been for the test, I would not have been motivated to learn that. Same with the false positive (eGFR). I was motivated to buy a book written by a Nephrologist and learned a lot about kidneys, which I wouldn't have done if it were not for being tested.
All knowledge gained about the human body comes in handy in order to live a healthy lifestyle. I know it was frustrating at the time it happened and I didn't think I was better off. But with hind sight, I was motivated to learn a lot. In the past I never gave much thought to thyroid function or kidney function. I just took them for granted.
The average person most likely would not be better off with lots of testing if they leave everything up to the doctor and don't try to learn from experience.
I have a neighbor/friend who doesn't believe in going to doctors. She doesn't have a doctor and did not sign up for medicare. She's in her early nineties and healthy.
Last edited by LongevitySeeker; 06-24-2022 at 11:14 AM..
Out of my expertise. Just my opinion like everybody else's but historically medical screening and treatments have been aggressive to start. The premise is that if one detects something early then the outcomes are better. Then we had aggressive treatments with regard to cancer to make sure no metastasis could present itself later on. Total mastectomies were the first option early on. The breast was removed thinking that it would metastasize to surrounding tissue or the other breast. Later on, it was postulated that the tumors were not metastatic but growths of their own. That theory allowed for lumpectomies in many cases of simply removing cancer and leaving the rest of the breast alone. I know a very young woman in her thirties that had one small lump and they took it out. They also used chemo to treat any possible other sites.
That same theory that lead to lumpectomies however meant that if there were de novo cancer growths later then what caused them? One then made reassessments of radiation effects and frequency. So we now have a balancing act with regards to exposure and the risk-benefit ratio of screening.
Right now my understanding is that they are trying to develop and explore better technology for screening. The final determinant however will be the outcome studies of doing it one way or another.
Again my information is limited so I don't claim to be on terra firma.
They may want better technology for screening but if they devoted time, quality time, to discussing the importance of a good diet and exercise, alot of that screening would be unnecessary. The Blue Zones again and again point to how important the "simpler" things of life are. And its not technology.
They may want better technology for screening but if they devoted time, quality time, to discussing the importance of a good diet and exercise, alot of that screening would be unnecessary. The Blue Zones again and again point to how important the "simpler" things of life are. And its not technology.
Good idea, but technology rules the day because that's where the money is. The healthcare and food industries are about making money, not improving our health. They will always favor the status quo regarding Lifestyle.
You're right about not needing cancer screening with a good diet, but who will determine what a healthy diet consists of? Dr. Campbell would say that good health will not result from eating animal protein, and he has the studies to back it up. But we live in a society where animal protein is the main focus of every meal. And those institutions, like the American Cancer Society and others are not going to lead the way away from the high consumption of animal protein. That's because they won't dare go against the food and healthcare industries. Dr. Campbell & Son tell the story much better than I can in the first and second edition of "The China study". The second (revised) edition does a good job of explaining why it will be nearly impossible to make any widespread changes for the better.
In my opinion, it seems our economy thrives on the results of people living unhealthy lifestyles.
And, as you know, it's not only about protein but processed foods too.
I go for regular checkups every six months. The nurse checks my weight, blood pressure and asks me what supplements I'm taking. Medications? none.
Then the doctor comes into the exam room and gives me the results of my blood work. That's it.
Then once a year he checks me by listening to my heart and lungs, in addition to giving the results of more blood work.
I never timed it but it could average about 10 minutes.
In my opinion, it's not so much about suggesting what you need to do to stay healthy as it is waiting for something to go wrong. Although I do get a pamphlet in the mail once a month from my HMO with basic health tips.
Someone once said: Health care is what you do for yourself at home, and medical care is what you get from your doctor when something goes wrong.
So I do my best not to need any medical care except for routine checkups.
It's much the same with me...I miss the doctors of yore who used to use their hands and skill to detect issues. Now it seems to be all labs and the prescription pad. My Doc never touches me except to check heart once a year.
I have high blood pressure and my PA "Doc" has never mentioned lifestyle changes such as low salt, exercise, weight control. I've learned to do that all on my own.
Doc told me the ONLY way to control HBP is with medications.
I've not found a local Doc who practices lifestyle medicine to help with any conditions (that might be reversed or eased) with diet and exercise. It's one negative of living in a small town with limited doctors.
Are labs an improvement over the educated touch and listening skills of a caring doctor??
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I am only 51.
Such as an x-ray to make sure there's no malformation or a biopsy to make sure there's no cancer. And they will never tell you how many tests they have in mind to begin with. They will just roll them out gradually, one at a time. That's why I never asked for a specialist, even though I had a question about how to adjust the formula. 
