Re: What is the deal on lab timing?

[Guest guest]

My Dr. has check my levels every 8 to 12 weeks for the past 28 yrs. If your

labs are paid for what does he care. You need to get leveled good and keep it

there and stay on top of Estradiol levels. Then when you have a handle on this

try every 3 to 4 months 6 months is to long your blood could be getting thicker

and this is to long to go not knowing it just tell them that.

My case is a bit complicated still every 8 weeks until your leveled good.

Co-Moderator

Phil

> From: Brett Savage <brshop@...>

> Subject: What is the deal on lab timing?

>

> Date: Friday, July 16, 2010, 3:26 PM

> I read about some having labs checked

> every 8 weeks.  Every doctor I have seen it seems like

> you have to fight and argue to get labs done.  New doc

> I just saw today thinks there is no need do labs but every 6

> months.  Maybe that's fine someday but right now until

> I get thinks worked out it just doesn't seem right to

> me.  I would like to be on a regular schedule so I know

> how I am doing and can make adjustments as necessary. 

> What do you all think about this?  I would especially

> like to hear about what our Doctors on this list

> think. 

> Thanks in advance,  Brett

>

>

[Guest guest]

Thanks Phil, What test do you have that tells you if your blood is getting

thicker?

Brett

Re: What is the deal on lab timing?

My Dr. has check my levels every 8 to 12 weeks for the past 28 yrs. If your

labs are paid for what does he care. You need to get leveled good and keep

it there and stay on top of Estradiol levels. Then when you have a handle

on this try every 3 to 4 months 6 months is to long your blood could be

getting thicker and this is to long to go not knowing it just tell them

that.

My case is a bit complicated still every 8 weeks until your leveled good.

Co-Moderator

Phil

[Guest guest]

A CBC if your Hemoglobin and Hematocrit are high this is what it means. I will

run a little over the top of the range if I don't drink a lot of water but I am

low on Aldosterone/Renin and take meds for this with Sea Salt my body dumps my

sodium due to my Adrenals not being told from my Pituitary to work right. I am

always Dehydrated and this will show blood thicker.

Co-Moderator

Phil

> From: Brett Savage <brshop@...>

> Subject: Re: What is the deal on lab timing?

>

> Date: Friday, July 16, 2010, 8:42 PM

> Thanks Phil,  What test do you

> have that tells you if your blood is getting

> thicker?

> Brett

> Re: What is the deal on lab

> timing?

>

>

> My Dr. has check my levels every 8 to 12 weeks for the past

> 28 yrs.  If your

> labs are paid for what does he care.  You need to get

> leveled good and keep

> it there and stay on top of Estradiol levels.  Then

> when you have a handle

> on this try every 3 to 4 months 6 months is to long your

> blood could be

> getting thicker and this is to long to go not knowing it

> just tell them

> that.

>

> My case is a bit complicated still every 8 weeks until your

> leveled good.

> Co-Moderator

> Phil

>

>

>

>

> ------------------------------------

>

>

[Guest guest]

>

> I read about some having labs checked every 8 weeks. Every doctor I have seen

it seems like you have to fight and argue to get labs done. New doc I just saw

today thinks there is no need do labs but every 6 months. Maybe that's fine

someday but right now until I get thinks worked out it just doesn't seem right

to me. I would like to be on a regular schedule so I know how I am doing and

can make adjustments as necessary. What do you all think about this? I would

especially like to hear about what our Doctors on this list think.

> Thanks in advance, Brett

>

The answer is: it depends on what the practitioner wants to do.

Generally, I like obtaining lab tests prior to the next appointment to help

assess the person's condition and help decide what adjustments may need to be

done. Labs would test factors that aren't easily obtained via the history and

exam. This interval keeps it simpler since patients may often forget to do

intermediate labs in the normal course of their daily activities.

The interval between appointments and tests then may vary depending on the

patient's severity of illness and the work that needs to be done to improve

function. As the patient improves and stabilizes, the frequency of appointments

and lab tests is reduced. Stable patients generally see me once every 6 to 12

months.

There may be times when intermediate and more frequent labs are needed.

For example, if the treatment has to monitor estradiol formation from

testosterone, then I may do intermediate labs to help decide when adding an

aromatase inhibitor needs to be done.

As another example, iron may need to be monitored more frequently than the

appointments because how fast a person absorbs iron varies tremendously. One

patient, for example, had his iron surge within a month from a ferritin of 10

ng/mL to 400 ng/mL using only 15 mg of iron a day. Usually, it would take

several months to even reach that level at 240 mg of iron a day. Thus, the need,

in certain patients to monitor iron absorption more frequently.

When giving transdermal testosterone, thyroid hormone levels may fall. This may

cause an increase in skin thickness or mucin deposition. This reduces absorption

of transdermal testosterone unless thyroid hormone is also adjusted. Thus, if I

was not seeing the patient in two months, an intermediate set of labs to help

determine adjustments may be needed between appointments.

When changes in a patient's condition may occur between appointments that

necessitate significant changes in their treatment, then intermediate labs to

help make that decision may be needed.

[Guest guest]

>

> I read about some having labs checked every 8 weeks. Every doctor I have seen

it seems like you have to fight and argue to get labs done. New doc I just saw

today thinks there is no need do labs but every 6 months. Maybe that's fine

someday but right now until I get thinks worked out it just doesn't seem right

to me. I would like to be on a regular schedule so I know how I am doing and

can make adjustments as necessary. What do you all think about this? I would

especially like to hear about what our Doctors on this list think.

> Thanks in advance, Brett

>

The answer is: it depends on what the practitioner wants to do.

Generally, I like obtaining lab tests prior to the next appointment to help

assess the person's condition and help decide what adjustments may need to be

done. Labs would test factors that aren't easily obtained via the history and

exam. This interval keeps it simpler since patients may often forget to do

intermediate labs in the normal course of their daily activities.

The interval between appointments and tests then may vary depending on the

patient's severity of illness and the work that needs to be done to improve

function. As the patient improves and stabilizes, the frequency of appointments

and lab tests is reduced. Stable patients generally see me once every 6 to 12

months.

There may be times when intermediate and more frequent labs are needed.

For example, if the treatment has to monitor estradiol formation from

testosterone, then I may do intermediate labs to help decide when adding an

aromatase inhibitor needs to be done.

As another example, iron may need to be monitored more frequently than the

appointments because how fast a person absorbs iron varies tremendously. One

patient, for example, had his iron surge within a month from a ferritin of 10

ng/mL to 400 ng/mL using only 15 mg of iron a day. Usually, it would take

several months to even reach that level at 240 mg of iron a day. Thus, the need,

in certain patients to monitor iron absorption more frequently.

When giving transdermal testosterone, thyroid hormone levels may fall. This may

cause an increase in skin thickness or mucin deposition. This reduces absorption

of transdermal testosterone unless thyroid hormone is also adjusted. Thus, if I

was not seeing the patient in two months, an intermediate set of labs to help

determine adjustments may be needed between appointments.

When changes in a patient's condition may occur between appointments that

necessitate significant changes in their treatment, then intermediate labs to

help make that decision may be needed.

[Guest guest]

Dr. no Welcome to the group and thanks for coming. If anyone wants to read

some of the posts Dr. M has made over the yrs. in the files section is a file

" nco7.zip " check it out.

Co-Moderator

Phil

> From: drmariano <drmariano@...>

> Subject: Re: What is the deal on lab timing?

>

> Date: Sunday, July 25, 2010, 6:22 PM

>

>

>

> >

> > I read about some having labs checked every 8

> weeks.  Every doctor I have seen it seems like you have

> to fight and argue to get labs done.  New doc I just

> saw today thinks there is no need do labs but every 6

> months.  Maybe that's fine someday but right now until

> I get thinks worked out it just doesn't seem right to

> me.  I would like to be on a regular schedule so I know

> how I am doing and can make adjustments as necessary. 

> What do you all think about this?  I would especially

> like to hear about what our Doctors on this list

> think. 

> > Thanks in advance,  Brett

> >

>

> The answer is: it depends on what the practitioner wants to

> do.

>

> Generally, I like obtaining lab tests prior to the next

> appointment to help assess the person's condition and help

> decide what adjustments may need to be done. Labs would test

> factors that aren't easily obtained via the history and

> exam. This interval keeps it simpler since patients may

> often forget to do intermediate labs in the normal course of

> their daily activities.

>

> The interval between appointments and tests then may vary

> depending on the patient's severity of illness and the work

> that needs to be done to improve function. As the patient

> improves and stabilizes, the frequency of appointments and

> lab tests is reduced. Stable patients generally see me once

> every 6 to 12 months.

>

> There may be times when intermediate and more frequent labs

> are needed.

>

> For example, if the treatment has to monitor estradiol

> formation from testosterone, then I may do intermediate labs

> to help decide when adding an aromatase inhibitor needs to

> be done.

>

> As another example, iron may need to be monitored more

> frequently than the appointments because how fast a person

> absorbs iron varies tremendously. One patient, for example,

> had his iron surge within a month from a ferritin of 10

> ng/mL to 400 ng/mL using only 15 mg of iron a day. Usually,

> it would take several months to even reach that level at 240

> mg of iron a day. Thus, the need, in certain patients to

> monitor iron absorption more frequently.

>

> When giving transdermal testosterone, thyroid hormone

> levels may fall. This may cause an increase in skin

> thickness or mucin deposition. This reduces absorption of

> transdermal testosterone unless thyroid hormone is also

> adjusted. Thus, if I was not seeing the patient in two

> months, an intermediate set of labs to help determine

> adjustments may be needed between appointments.

>

> When changes in a patient's condition may occur between

> appointments that necessitate significant changes in their

> treatment, then intermediate labs to help make that decision

> may be needed.

>

>

>

> ------------------------------------

>

>

[Guest guest]

Wow Dr. M I am sorry this took so long to come up this is not the norm here.

Co-Moderator

Phil

> From: drmariano <drmariano@...>

> Subject: Re: What is the deal on lab timing?

>

> Date: Sunday, July 25, 2010, 6:22 PM

>

>

>

> >

> > I read about some having labs checked every 8

> weeks.  Every doctor I have seen it seems like you have

> to fight and argue to get labs done.  New doc I just

> saw today thinks there is no need do labs but every 6

> months.  Maybe that's fine someday but right now until

> I get thinks worked out it just doesn't seem right to

> me.  I would like to be on a regular schedule so I know

> how I am doing and can make adjustments as necessary. 

> What do you all think about this?  I would especially

> like to hear about what our Doctors on this list

> think. 

> > Thanks in advance,  Brett

> >

>

> The answer is: it depends on what the practitioner wants to

> do.

>

> Generally, I like obtaining lab tests prior to the next

> appointment to help assess the person's condition and help

> decide what adjustments may need to be done. Labs would test

> factors that aren't easily obtained via the history and

> exam. This interval keeps it simpler since patients may

> often forget to do intermediate labs in the normal course of

> their daily activities.

>

> The interval between appointments and tests then may vary

> depending on the patient's severity of illness and the work

> that needs to be done to improve function. As the patient

> improves and stabilizes, the frequency of appointments and

> lab tests is reduced. Stable patients generally see me once

> every 6 to 12 months.

>

> There may be times when intermediate and more frequent labs

> are needed.

>

> For example, if the treatment has to monitor estradiol

> formation from testosterone, then I may do intermediate labs

> to help decide when adding an aromatase inhibitor needs to

> be done.

>

> As another example, iron may need to be monitored more

> frequently than the appointments because how fast a person

> absorbs iron varies tremendously. One patient, for example,

> had his iron surge within a month from a ferritin of 10

> ng/mL to 400 ng/mL using only 15 mg of iron a day. Usually,

> it would take several months to even reach that level at 240

> mg of iron a day. Thus, the need, in certain patients to

> monitor iron absorption more frequently.

>

> When giving transdermal testosterone, thyroid hormone

> levels may fall. This may cause an increase in skin

> thickness or mucin deposition. This reduces absorption of

> transdermal testosterone unless thyroid hormone is also

> adjusted. Thus, if I was not seeing the patient in two

> months, an intermediate set of labs to help determine

> adjustments may be needed between appointments.

>

> When changes in a patient's condition may occur between

> appointments that necessitate significant changes in their

> treatment, then intermediate labs to help make that decision

> may be needed.

>

>

>

> ------------------------------------

>

>