Latest / Doctor Turned Health Coach / So Many Health Tests, Which is Right For You?

Transcript

So Many Health Tests, Which is Right For You? · Doctor Turned Health Coach

• 0:00
  Welcome to Doctor Turned Health Coach. My name is Dr.
• 0:03
  Ashuri, family medicine physician turned health coach. Why?
• 0:08
  Because I think there is a better way to help people through their health journey
• 0:13
  than just having a 7 or 10 minute appointment where we do a quick blood test,
• 0:19
  we prescribe a medication, and send them on their way.
• 0:23
  So today on this beautiful morning, I'm in a park called Juniper Park. It's in Bend, Oregon.
• 0:31
  This is where me and my wife are currently traveling. She's working here and
• 0:36
  I'm seeing my virtual online health coaching clients.
• 0:41
  And a recent wonderful article came out by the Lancet.
• 0:44
  Lancet is a well-established journal that does a lot of unbiased review of current literature.
• 0:52
  And this one was specifically about dementia.
• 0:54
  The great news about dementia, which is something that we've known for a long
• 0:59
  time, is that it is preventable.
• 1:02
  Preventable diseases are at the heart of what I obsess over every day.
• 1:07
  If i can prevent arthritis back pain
• 1:10
  depression heart disease diabetes cancer dementia
• 1:14
  then i want to do everything possible for a
• 1:18
  client with a client to help them achieve that if
• 1:21
  that is something that is important to them so at the heart of this recent literature
• 1:26
  search that the lancet did was testing testing should we do blood marker testing
• 1:33
  should we do a spinal tap Should we do amyloid PET scans?
• 1:38
  All these different ways of determining
• 1:40
  if somebody has the propensity for developing a certain condition.
• 1:47
  In this podcast, I just wanted to briefly touch on this because there's a lot
• 1:50
  more tests being marketed to the average consumer.
• 1:54
  Classic ones that we see a lot are the advanced cholesterol screening tests.
• 1:59
  We have coronary artery calcium scores.
• 2:03
  For diabetes, we can see the CGM monitors that you attach to your nowadays arm
• 2:08
  and you monitor your blood sugar.
• 2:10
  You're looking for early, early, early signs of insulin resistance and many
• 2:17
  other types of whole body MRIs and blood tests that screen for early cancer.
• 2:24
  One of the main limitations of these tests is that yes, a lot of people who
• 2:30
  end up with a particular disease like diabetes,
• 2:34
  cancer, or heart disease will have abnormalities on those tests.
• 2:40
  So if we take a look at everybody who developed heart disease and diabetes,
• 2:45
  they definitely had an abnormal coronary artery calcium score,
• 2:50
  abnormal CGM, abnormal insulin markers.
• 2:55
  However, there is also a lot of people who have those abnormalities,
• 3:00
  but they never developed an actual disease.
• 3:02
  And the problem with doing these kind of tests is that we might cause unnecessary
• 3:08
  fear and anxiety, or even worse,
• 3:12
  somebody might start taking certain actions based on these numbers that will
• 3:17
  take them down the wrong direction.
• 3:19
  Western medicine is fantastic with certain technology, amazing when it comes
• 3:24
  to certain treatments, but it is also a field of science where we take a hypothesis
• 3:30
  and we go with it and we decide...
• 3:33
  If this hypothesis can help us make a certain decision.
• 3:38
  But it's just a hypothesis. It's not clear-cut evidence.
• 3:43
  And that's maybe, I think, the beauty of Western medicine. So in this particular
• 3:48
  example, I kind of want to go over a few things.
• 3:51
  One is a CGM. If you wear this CGM monitor and you attach it to your arm,
• 3:55
  you'll see a few blood sugar spikes based on stress, based on exercise,
• 4:01
  poor sleep based on what you eat.
• 4:03
  And yes, sometimes these spikes can be problematic, but if you set out to try
• 4:09
  to basically flatten these spikes and never get them, number one,
• 4:14
  you have a full-time job of trying to manage your blood sugar.
• 4:18
  Number two, there is no proof that people who have these elevated blood sugars
• 4:23
  will go on to develop diabetes.
• 4:25
  If your goal is to prevent diabetes, then this will not get you there.
• 4:29
  It may not get you there. It might get you there. It may not get you there.
• 4:33
  If your goal is to aim for longevity because you believe that with more flattened
• 4:40
  blood sugars you'll live longer, there's no evidence for that.
• 4:43
  And there's nothing wrong with doing it. If it seems simple to you,
• 4:46
  if you've already maxed out all the other life interventions,
• 4:50
  I think it is perfectly okay to do something like that.
• 4:54
  And of course, there's all these other tests that are available now.
• 4:57
  There's the gallery test, which is a very fancy, expensive blood test that will
• 5:01
  look for cancer markers.
• 5:03
  There's the whole body MRIs.
• 5:06
  I think Ezra, or there's a couple of companies now, both internationally in
• 5:10
  the U.S., that will do full body MRI scans, anywhere from $2,000 to $3,000.
• 5:15
  And I'm not too worried about the cost, because we do live in a country where
• 5:19
  a lot of people have disposable income. And if that disposable income is something
• 5:25
  that they believe is worthwhile, there's nothing wrong with spending it towards preventing a disease.
• 5:29
  But the question always is, what is the most powerful lever that we can manipulate
• 5:38
  to change our overall health outcome?
• 5:41
  Is it to measure our daily blood sugar fluctuations or is it to choose the foods
• 5:48
  and nutrition and lifestyle and diet and sleep that tends to already kind of
• 5:53
  stabilize our blood sugar?
• 5:55
  And is diabetes really only a disease of elevated blood sugars or is it also
• 6:00
  a disease of inflammation,
• 6:02
  of poor insulin receptor metabolism, of glucose metabolism, right?
• 6:10
  It could be a multifactorial disease that we just yet haven't teased out.
• 6:14
  Same with saturated fat intake. Is heart disease really just a problem of saturated fat?
• 6:19
  Then why do people who are vegans get heart disease? So obviously it's not that simple.
• 6:25
  I think we can still develop a wonderful approach to overall help prevent these chronic diseases.
• 6:30
  So when it comes to deciding on whether you should get a particular test.
• 6:35
  My barometer is, has this test been proven effectively and shown that it can
• 6:42
  help me prevent this particular disease? Then yes, I will do it.
• 6:45
  If it hasn't, then I think I will keep it there in the background and I will
• 6:49
  think about it, but I will take the upstream, I will make the upstream choices
• 6:54
  that are very likely to lead to very good health outcomes.
• 6:58
  For most tests, unfortunately, we're still sort of in this early phase where it may not tell us much.
• 7:05
  Not for blood pressure, not for cholesterol.
• 7:07
  Those are pretty good. We can make some pretty important decisions off of that,
• 7:11
  and we tend to be correct.
• 7:13
  Hemoglobin A1c, we can say that, well, if your hemoglobin A1c is 6.4,
• 7:17
  it's not far from developing diabetes at 6.5.
• 7:21
  So those can be better markers, and those may make sense to do.
• 7:25
  But of course, if you just do those tests, you're looking for a disease,
• 7:28
  but you're not preventing a disease. So prevention is always upstream.
• 7:33
  Screening is in the middle and treating the disease is sort of the last resort.
• 7:38
  I hope this is of value to you guys. If you want help with your health coaching
• 7:42
  issues, if you have questions about your health, if you want to live better,
• 7:47
  spend less money on Western medical interventions and treatments and disease
• 7:51
  and spend less years treating cancers and heart disease, book a session with
• 7:57
  me. You can go to drashori.com.
• 8:00
  The information is in the show description.
• 8:02
  Book a free 15-minute consult and just run your situation by me.
• 8:07
  I do hourly coaching and I do my monthly coaching program. Thank you so much for listening.