I have been working on improving the health of the cells in my body, with some success, for a while now. This year, however, I have decided to monitor the situation with what are essentially weekly blood tests. I started out the year with blood tests every 4 weeks, but in May I moved to weekly tests. Apart from a short period when on holiday I have had at least one blood test each week since May 5th 2022.
I have found this a particularly useful process, but in doing this I have learnt some things that are I think important for others to know. Hence I thought I would write this blog post.
I have used a number of different Laboratories. Most Laboratories offer a form of general health screen which covers basic biochemistry and the health of various organs such as the kidneys, liver and heart. The selection of tests often varies in detail, but certain tests such a Creatinine and Haemoglobin tend always to be done. I was concerned, however, that I did not think some of the results were accurate. Hence I checked out the Labs by having a sample sent to more than one lab from the same puncture in my arm.
Lesson 1: Time matters
The most important thing I have learnt is that it really matters to get the time between having the blood drawn from your arm and the test actually performed to a minimum. Although some things such as the level of Sodium ions in the blood serum don't change other things do. And this can matter. The Labs don't always warn you about this. Some labs have you post the sample to them. For some tests this makes the result gradually go wrong as time goes by. I will give some examples.
Creatinine
Creatinine is a chemical in the blood that is used as a simple measurement of kidney health. However, if blood is left standing around at room temperature for any period of time the level of creatinine in the blood goes up. This can really matter.
In June I sent a sample to two labs. One said my creatinine level was 85.64 mcmol/L the other said it was 122 mcmol/L. A level of over 120 mcmol/L would indicate I had a kidney disease. In fact by getting a test done really quickly later in the year I had a creatinine level of 61.82 mcmol/L. The reason for the high level of creatinine from one lab was postal delay.
I did a similar test in November 2022 sending a sample to three labs. The lab I drove the sample to gave a result of 73.43 mcmol/L, the one that used a courier gave a result of 83 mcmol/L and the one that relied on the post gave a result of 93 mcmol/L. My concern about this is that Labs should tell people that delays are likely to give wrong creatinine indications and report that kidneys are not as healthy as they really are. There is even a risk that people have unnecessarily biopsies because of delays in testing.
HbA1c - Glycated Haemoglobin
This measures the level to which Haemoglobin (which carries oxygen) has reacted with glucose. It indicates average blood sugar levels and is used as a primary indicator of Diabetes. Oddly enough this also appears to increase when blood waits before testing. Sadly I don't actually have more than one result from the same lab, but I do have a range of results which makes me think that of the order of 1/2 % on the percentage and say 5 mmol/mol occur for each day's delay in testing.
Because this is used for diagnostic purposes this worries me as well.
Edit 24/12/2022
I have since further studied HbA1c and I find that gylcated haemoglobin goes through two processes. First the haemoglobin reacts to create an aldimine then that further reacts to change into ketoamine. The first part is labile in that is readily easily reversible and it follows blood glucose by about 2 hours (going both up and down). The second part is much harder to reverse, but is very slightly reversible. It, however, can be assumed that it is not going to reverse for the purposes of analysing the figures. Hence it does stay up. This means that HbA1c in blood can go up (and glucose down) in the period between drawing blood and the test. Importantly, however, some analyzers can distinguish between the temporary aldimine and the ketoamine. Some, however, get influenced by the aldimine. Hence you will get higher HbA1c from the analysers that include some or all the effect of the aldimine and it will be more subject to variation.
Further info
End of Edit
Others
There are other biomarkers that metabolise such as Phosphate, but the labs seem to recognise this.
Lesson to Learn: Time matters
Lesson 2: Different Analysers get different results
A piece of equipment called an analyser is used to analyse blood. That produces a measure in terms of concentration, but those measures are not necessarily directly comparable. Hence it is best to look at the healthy range for the lab concerned and compare the position on that range to another lab's result on their range. This makes things all a little bit complicated and difficult to compare between Labs.
Sadly it can be difficult to always use the same Lab, but the notes above should assist when trying to compare results between Labs. Sometimes a Lab will change their analyser and that is also an issue as to comparability.
I have found this a particularly useful process, but in doing this I have learnt some things that are I think important for others to know. Hence I thought I would write this blog post.
I have used a number of different Laboratories. Most Laboratories offer a form of general health screen which covers basic biochemistry and the health of various organs such as the kidneys, liver and heart. The selection of tests often varies in detail, but certain tests such a Creatinine and Haemoglobin tend always to be done. I was concerned, however, that I did not think some of the results were accurate. Hence I checked out the Labs by having a sample sent to more than one lab from the same puncture in my arm.
Lesson 1: Time matters
The most important thing I have learnt is that it really matters to get the time between having the blood drawn from your arm and the test actually performed to a minimum. Although some things such as the level of Sodium ions in the blood serum don't change other things do. And this can matter. The Labs don't always warn you about this. Some labs have you post the sample to them. For some tests this makes the result gradually go wrong as time goes by. I will give some examples.
Creatinine
Creatinine is a chemical in the blood that is used as a simple measurement of kidney health. However, if blood is left standing around at room temperature for any period of time the level of creatinine in the blood goes up. This can really matter.
In June I sent a sample to two labs. One said my creatinine level was 85.64 mcmol/L the other said it was 122 mcmol/L. A level of over 120 mcmol/L would indicate I had a kidney disease. In fact by getting a test done really quickly later in the year I had a creatinine level of 61.82 mcmol/L. The reason for the high level of creatinine from one lab was postal delay.
I did a similar test in November 2022 sending a sample to three labs. The lab I drove the sample to gave a result of 73.43 mcmol/L, the one that used a courier gave a result of 83 mcmol/L and the one that relied on the post gave a result of 93 mcmol/L. My concern about this is that Labs should tell people that delays are likely to give wrong creatinine indications and report that kidneys are not as healthy as they really are. There is even a risk that people have unnecessarily biopsies because of delays in testing.
HbA1c - Glycated Haemoglobin
This measures the level to which Haemoglobin (which carries oxygen) has reacted with glucose. It indicates average blood sugar levels and is used as a primary indicator of Diabetes. Oddly enough this also appears to increase when blood waits before testing. Sadly I don't actually have more than one result from the same lab, but I do have a range of results which makes me think that of the order of 1/2 % on the percentage and say 5 mmol/mol occur for each day's delay in testing.
Because this is used for diagnostic purposes this worries me as well.
Edit 24/12/2022
I have since further studied HbA1c and I find that gylcated haemoglobin goes through two processes. First the haemoglobin reacts to create an aldimine then that further reacts to change into ketoamine. The first part is labile in that is readily easily reversible and it follows blood glucose by about 2 hours (going both up and down). The second part is much harder to reverse, but is very slightly reversible. It, however, can be assumed that it is not going to reverse for the purposes of analysing the figures. Hence it does stay up. This means that HbA1c in blood can go up (and glucose down) in the period between drawing blood and the test. Importantly, however, some analyzers can distinguish between the temporary aldimine and the ketoamine. Some, however, get influenced by the aldimine. Hence you will get higher HbA1c from the analysers that include some or all the effect of the aldimine and it will be more subject to variation.
Further info
End of Edit
Others
There are other biomarkers that metabolise such as Phosphate, but the labs seem to recognise this.
Lesson to Learn: Time matters
Lesson 2: Different Analysers get different results
A piece of equipment called an analyser is used to analyse blood. That produces a measure in terms of concentration, but those measures are not necessarily directly comparable. Hence it is best to look at the healthy range for the lab concerned and compare the position on that range to another lab's result on their range. This makes things all a little bit complicated and difficult to compare between Labs.
Sadly it can be difficult to always use the same Lab, but the notes above should assist when trying to compare results between Labs. Sometimes a Lab will change their analyser and that is also an issue as to comparability.
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