Dr. Amy Nett: So the True Health Diagnostics panel I generally order either when I want additional markers on the blood lipid panel, so specifically on the True Health Diagnostics panel you’re going to get markers that include LDL-P, oxidized LDL, Lp-PLA, Apo B, HDL-P, fibrinogen, Apo B/A, so you’re going to get a lot of those advanced markers. So I get it when I really want to stratify patients further into cardiovascular disease risk groups. Or if you see some markers of blood sugar imbalances, again you’re going to get all of those markers that relate to beta cell strain, insulin resistance, blood sugar regulation. So if I have questions about metabolic syndrome or cardiovascular disease risk profile, that’s normally when I order it.
In terms of how to interpret the results, so we’re going over a lot of the results, but the advanced markers, we’re probably not going to do in this particular ADAPT course. There may be a one-off in terms of how to interpret the advanced lipid markers. You can, for the most part, and this is also a follow-up to one of the questions from last week about do we have guidelines or functional ranges. I asked Chris if he uses the same ranges because I more or less go by what the ranges are provided for the THD panel.
So we use more or less the ranges and when you get the THD panel back you’ll see that they put those lab ranges in the green, yellow, or red column like optimal, intermediate risk, or high risk. So you can more or less use that, but just also remember to take into account the clinical context or the question from last week was, can you tell the degree of beta cell destruction in their functional ranges? So, for example, let’s say you have a question about a patient, fasting blood sugar is 122, hemoglobin A1c is 6.9. So you want to say, okay, what’s that degree of beta cell strain and insulin resistance? So you would get that. You can then look at those markers and get a sense as to whether they’re intermediate risk, high risk, what the degree of beta cell destruction is. You can’t quantify it in terms of like a specific percent of beta cell destruction, it just gives you a general picture. But also put it in context.
I have one patient who really just likes to stay on top of all of his biomarkers and kind of hack everything and so we get a THD panel on him every two months. He wears a continuous glucose monitor and I know he tends to be on the lower-carb side. His insulin tends to be about two. So that’ll put you into an intermediate risk category. But that’s not because he has beta cell strain, that’s actually because he’s just eating really low carbohydrate and not producing insulin. So take it into context but that you’ll get guidelines in terms of how to interpret that. And they provide a lot of useful information on that panel. So I think that’ll help you interpret it. And you can always do some digging through PubMed if you have specific questions, what do I do with Lp-PLA(2) or you know, that sort of thing. Just do a little bit of PubMed searching to get more articles. But I think you’ll see there’s a lot of information just on the THD panel itself.