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Hello...I have scheduled my annual physical for next week and was wondering if there were any specific tests that I should request of my physician (within reason) which may not normally be performed, in order to get a better assessment of my health. Any recommendations along with a brief 'why' would be really appreciated.

Have a great weekend!

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5 Answers

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In addition to the normal lipid work up and thyroid panel work up, I would ask for a NMR lipoprofile test which will tell you the amount of small dense LDL particles vrs large bouyant particles.

A VAP test also does essentially the same thing as the NMR Lipoprofile.

Just be aware your physician may not up to speed on the importance of LDL particle size. I would go in armed to the teeth with info regarding the destructive effects of sdLDL particles on the vascular system.

I would also ask for a serum Vit D3 level. (25) OH Hydroxy test. Our Dr K on this site wants his patients to be 70-100ng/mL level. Be aware that dark skinned folks do not manufacture as much Vit D3 from the sun as compared to light skinned people so supplementation with a olive oil based Vit D3 is important. Most Americans have been scared of the sun due to melanoma and have been avoiding the sun with sunblock and are very low in Vit D3...regardless of skin composition.

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if you're generally happy with your lipid numbers is it still a good idea to get a NMR lipoprofile test the next time you get bloodwork done? – tartare Apr 15 2011 at 22:22
Yes, because you may have TC in the 230 range, HDL over 70, LDL around 100 or more and have a high percentage of sdLDL. We do know that no wheat, no sugar, no refined veg oils is susposed to send the large bouyant LDL up as a percentage of total LDL. Get it done once so you will know your current eating regime is working. If your percentages are not where you want them, then you can tweak your eating regime by either decreasing carbs and/or increasing fat to alter the composition of the LDL. – Dexter Apr 15 2011 at 22:34
And there is this posting by Dr Davis about the relationship of triglycerides and LDL particle size. heartscanblog.org But do note that genetics does play a part in your LDL particle size. – Dexter Apr 15 2011 at 22:39
interesting. I had my blood work done last year before I knew to ask for some of these tests, all looks pretty good, but I do wish I had the full picture. No Vit D levels on this test..etc. – tartare Apr 15 2011 at 22:42
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One caveat on the additional blood test. If your test don't come back within the "normal" ranges and they are not the standard tests any Dr. would perform for an annual, you may want to re think testing for testing sake. If you ever apply for insurance, (life, health, disability, long term care, etc) and there is something the insurance company doesn't like, it could cause problems.

Just a thought. If you are happy with the way you look, feel and perform the added test are really not all that necessary. If you are 20 and think you will never need insurance, think hard.

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That's an excellent point (and quite timely), as I am about to be applying for life insurance. Perhaps I will wait until next time for some of these other tests. Great suggestions, though, from everyone. Thank you. – Jon Apr 16 2011 at 0:27
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I think there is a cadre of testing that needs to be done.....VO2 max, calcium index scoring, ultra sensitive CRP, dexa scanning, complete hormone panels including reverse t3 and thyroid antibodies measures, omega six/three index, and a neurocognitive battery are some I would get......there are others but it gets pricey for most.

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And a vit D level is critical too....... – The Quilt Apr 15 2011 at 22:56
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you have a pulse, you are defying gravity - if it ain't broke, don't fix it.

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One that comes to mind is a

Vitamin D 25 test, measure the level of active Vitamin D in your blood.

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