My general feeling about all the testing discussed here is that people are doing too much, and often don’t fully understand the results. But Dr Stanfield has put at a great video that says it better than I can, so I think it’s worth a view.
My guiding principle at work and for my own health is “if it won’t change your treatment (plan), then don’t get the test.
How would you know if it would change your treatment plan unless you get the test in the first place?
I agree that the “incidentalomas” are highly problematic. I quite worry about people in my life who are always over-medicalizing everything and over-testing things.
The answer is somewhere in the middle.
Regular doctors aren’t doing enough, but functional medicine doctors are doing too much.
Exactly, I use testing and blood panels probably more than most on this site… to see changes good or bad when making medication changes.
Sticking to bio-markers of Inflammation and Methylation DNA over past 3 years has been helpful in seeing patterns.
Good to know my biological age is significantly lower then chronological (12 - 20 years).
If you don’t know how it would change your plan, then why are you getting the test?
Example: patient goes to their doctor for congestion and fever. Do you get a flu test? What will treatment be if test is negative? What will treatment be if test is positive?
I’ll give another example. Feel free to disagree. I’m sure some will.
In my opinion, the main value of Dexa scan is to find “skinny fat” people. If someone is obviously overweight, should they do a dexa? What will treatment be regardless of results?
Yea I look at DEXA scans as more of a personal curiosity thing than anything else. I think the mirror tells us enough.
Ok fair enough. I didn’t even consider tests like that.
Great question. You imagine that you already got the results and imagine them at different levels and ask yourself if this information gives you something that you can do. As an example if you imagine you test your LDL level and that it comes out as elevated, you can think that as a result you could take measures to lower your LDL such as with statins. You will find that some parameters are mostly useless to test because it doesn’t matter if they are high or low, you can’t do anything about them, or they don’t give you an indication of anything that you can influence. Such parameters can still be useful to test but typically rarely.
I understand his point of view, but it doesn’t appear very forward thinking to me. His point about thyroid cancer in South Korea says more about the need to find better treatments for thyroid cancer than whether screening is a good idea. Broadly, I think the issue I have with his position is that he’s saying don’t do anything until you have symptoms, but it’s obvious that model isn’t serving people. He’s essentially saying we don’t know a lot and testing just makes things more uncertain. Anomalies in scans causing cascade of more tests is a symptom of medicines lack of knowledge to make an informed decision about whether it’s ok to treat something or not. A great way around that issue is to build up a massive data bank of MRI’s scans and get then use AI to look for patterns of health and disease. It’s not good enough to say, that’s all we know, so let’s not look any deeper just in case we mess things up.
I always hear the reason not to do full body MRI’s is because so many people do invasive procedures that might cause more harm than good.
I don’t know the circumstances in which this happens, or if people just don’t have very good doctors? I can only share that over 10 years ago, a thyroid and lung nodule were found. The only thing that was recommended was another test in a year to see if they grew or remained stable. My thyroid nodule grew over the next couple of years, so at that point they did a biopsy. They never touched my lung, and in fact, I’ve been told at this point, my thyroid and lung nodules have been stable for so long, it’s time to stop looking.
Recently, through a full body MRI, they found a spot on my pancreas and only recommended I look at it again in a year.
I’m really glad I have this information. And yes, @KarlT, dexa let me know that I’m skinny fat! I’m now less fat as a result! 
I’ve had two fully body MRIs (a year apart) with no findings. Personally, having two now with zero findings is not only reassuring, but helps as a baseline for future MRIs.
And the mirror is far less expensive. Especially when applied to a whole population.
There are many standard guidelines developed by different medical associations for which “nodules” need biopsies. You are fortunate that yours didn’t, but many people will need biopsies.
On a regular basis I refer patients to a nodule clinic for nodules I see on chest x-rays. Many of these patients end up getting biopsies.
The thing to keep in mind is that with AI and machine learning, the value of these tests will increase, as those technologies get better and better at correct diagnosis. This will cut down on the need for biopsies and other invasive and potentially harmful interventions. The progress in this field is very rapid. For some areas these are already better than humans.
You may be right, but I doubt anything changes soon. Too many limitations with the current technology.
I had a DEXA scan ~9 months ago (as a baseline) and will repeat it again in a few months. I am planning to repeat every 1-2 years and I think it’ll be helpful for tracking body composition and bone density over time (& prompting changes if I don’t like the trajectory). For this years repeat scan, I am most interested in bone density as I have been taking Vit D & K and introduced rucking and other weight bearing exercises. The datapoint from the scan will inform whether I’m on the right track or if I should consider iterating.
Hmmm… are yiu considering Taurine with your vitamin D 3 and K2?
Was helpful to me and a few others. Put it in your coffee… done.