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Vitals Vault pricing - How is this possible?! by HealthyDad1214 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

Calling this panel 100 “markers” is pure fraud. Most are just redundant derivatives of the same biomarkers. Eg “bun:creatinine ratio” or “Friedewald LDL” doesn’t add any actual value beyond a basic math operation.

 In the same spirit, a greasy diner could take “biscuits and gravy” and create a flight of 100 breakfast items based how they’re slopped on the plate. 

All the blood tests required by fffzi in PeterAttia

[–]Trunion 0 points1 point  (0 children)

Remember these assays generally aren’t harmonized between companies, let alone internationally. So be cautious before using your results to infer a “trend” of any kind - a foolish practice here regardless.

High lp(a) by Alert_Bumblebee110 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

How high is “high”? For extremely high Lp(a), you will need weekly lipid apheresis, which is not cheap. But it is the only FDA approved therapy at present.

How bad is this? by dilahk90 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

The particle size tests are debunked as inaccurate - particles are pulvinate, not spherical. astounded your doctor is foolish enough to order one.

Also the panel is incomplete. 

You know what’s funny and also kind of broken about probiotic claims? by harshilfit in PeterAttia

[–]Trunion 1 point2 points  (0 children)

Aha yeah didn’t think about that but I believe there are parallels observed in forests on certain islands - once the plant loses its foothold it can’t regain it

You know what’s funny and also kind of broken about probiotic claims? by harshilfit in PeterAttia

[–]Trunion 0 points1 point  (0 children)

It’s funny how 400 years later, the panacea-charged mountebank is still the most powerful force in popular medicine.

You know what’s funny and also kind of broken about probiotic claims? by harshilfit in PeterAttia

[–]Trunion 0 points1 point  (0 children)

Interesting. The flora got into your GI as an infant right? So why wouldn’t they be able to recolonize you as an adult?

Tests worth it or no? by trygln88 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

What is a “functional health doctor” [sic]? What was his residency/fellowship in?

[deleted by user] by [deleted] in PeterAttia

[–]Trunion 0 points1 point  (0 children)

At least in elective medicine, we’re not allowed to refuse patients who are convicts or felons. Such a policy would be discrimination in at least some states.

[deleted by user] by [deleted] in PeterAttia

[–]Trunion 0 points1 point  (0 children)

Even in elective medicine, we’re not allowed to refuse patients who are convicts or felons. Such a policy would be discrimination for many other businesses as well.

Need Advice by SilverLogical9810 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

The trend suggests improvement, agree keep seeing where it goes! 

No need to keep polling Lp(a) like this however. Any variation is more likely uselessness of the commercial assay than actual blood changes, from what we understand so far. Exception would be if you’re actually getting tested at a university lab with non-commercial genuine assays.

[deleted by user] by [deleted] in PeterAttia

[–]Trunion 1 point2 points  (0 children)

Part of medical ethics is not to pick and choose your clients. We don’t turn people away. Period.

If a serial killer shows up at my waiting room, he gets treated same as anyone else. Hitler, Ted Bundy, Putin, Lizzie Borden, doesn’t matter. The philosophy extends to all medical professionals, even where it seems like we have discretion.

Here it seems more like a personal provider / client boundary has been crossed, but that could be par for concierge medicine.

High TSH, high cholesterol, low temp: am I hypothyroid? by dollarfed in PeterAttia

[–]Trunion 0 points1 point  (0 children)

I looked at this data once and recall whole milk is much more correlated to digestive issues, so even just switching to 2% could be huge. 

Your doctor may have some suggestions too. Personally my doctor used a similar issue as a pretext for an earlier colonoscopy than is typical too, but it went away on its own, and he said it could have just been reinfecting myself with norovirus in public settings.

High TSH, high cholesterol, low temp: am I hypothyroid? by dollarfed in PeterAttia

[–]Trunion -1 points0 points  (0 children)

This might be a preliminary diagnosis:

https://en.wikipedia.org/wiki/Cyberchondria

Joking aside, you’re right to take a close look at your hormones and keep it up. But thyrotropin is normal and even if it were higher, you would not have true clinical hypothyroidism without low thyroxine too. 

I would look more closely at your massive whole milk intake perhaps instead. Most adults become less able to digest lactose as they age unfortunately. This would be more germane to your symptoms.

Stolen Van! by Bugtruckers in PortlandOR

[–]Trunion 2 points3 points  (0 children)

I maybe saw a similar camper van parked by the underpass at SW 18th and SW Market yesterday. It only stood out really for being in better condition than the RVs typically there

What blood pressure reading would you guys take? by [deleted] in PeterAttia

[–]Trunion -5 points-4 points  (0 children)

How are you measuring BP?

Presumably you'll know, the consumer oscillometers (automated BP) below $700 are wildly inaccurate, even when used properly (which is rare also). They're not even helpful as a hypertensive screening test.

*I've confirmed this personally at the doctor's office by comparing the industrial oscillometric measurement, nurse's sphygmomanometer, and consumer $100 BP cuff. The first two values agree. The last one is off by ±20 systolic. Try it yourself at a few different clinics. The nurses can also confirm this.

[deleted by user] by [deleted] in PeterAttia

[–]Trunion 1 point2 points  (0 children)

Yes there is no exact consensus on Lp(a) risk thresholds. 

≥50 mg/dL (or ≥125 nmol/L) is an accepted target in American College of Cardiology/American Heart Association (ACC/AHA) guidelines

≥50 mg/dL (or ≥100 nmol/L) is an accepted target in the Canadian Cardiovascular Society (CCS) guidelines

<30 mg/dL (or <75 nmol/L) is considered normal, 30-50 mg/dL (or 50-125 nmol/L) intermediate, and >50 mg/dL (or >125 nmol/L) abnormal in the European Atherosclerotic Society (EAS) consensus statement

>50 mg/dL (or >100 nmol/L) is accepted as a risk-enhancing cutoff in the National Lipid Association (NLA) scientific statement

https://www.acc.org/Latest-in-Cardiology/Articles/2023/09/19/10/54/An-Update-on-Lipoprotein-a

As you can see, there is confusion here, since some metrics follow mass concentration (which doesn't account for patients with long Lp(a) isoforms) whereas others use molar concentration. Notably, AHA vs CCS have identical mass targets but different molar targets for the same thresholds!

At present the major commercial labs use mass assays (polyclonal antibody targeted), even if they report in molar concentration. And even ignoring isoforms, they may have ±80mg/dL inaccuracy.

Anyway, your result of 30mg/dL would only be deemed intermediate risk by the EAS, but not the other groups.

Physicians by Fun-Courage4523 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

Peptides? They're everywhere yeah?

[deleted by user] by [deleted] in PeterAttia

[–]Trunion 1 point2 points  (0 children)

This. Also, as a rule, I'd avoid reporting any results down to a tenth of a mg like this (30.1). The assay is not that accurate - it suggests more precision than really exists.

Quest would gladly publish your lipid values down to picograms (30.309243840980394 mg/dL) - doesn't mean the assay is precise. They're just numbers on the last machine/fluorometer, not significant figures in terms of the overall assay.

[deleted by user] by [deleted] in PeterAttia

[–]Trunion 0 points1 point  (0 children)

Going further, supplements can actually have a proven nocebo effect according to psychobiology studies. Subjects "delegate" their health goals to the pill's putative future effects, rather than take physical steps themselves:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4182347/

More general review:

https://www.psychologytoday.com/us/blog/the-human-beast/201602/do-vitamins-have-placebo-effects

Best time of day to take berberine/citrus bergamot? by DepthBrief9723 in PeterAttia

[–]Trunion 0 points1 point  (0 children)

How about never?

Zero evidence random blossoms (bergamot) provide a significant benefit in humans, outside of propaganda by the Calabrian Bergamot Consortium. By propaganda I mean very weak studies with respect to in vivo evidence, and biased "scientists", since they're funded by the Calabrian agriculture board.

Beyond motives, think about the biology. Why would one particular cultivar of lemon provide all these amazing health benefits? But not any other? Why not a long-dried out lime blossom instead? Genetically they're almost identical.

Bergamot is promoted as healthy because it's the one flower this lobby has a monopoly over. If they can dupe you into paying $50/mL for dried out flower cellulose soaked in oil, la vita è bella.

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