Blood Tests for Healthy People
Gentle reader. Observe the picture above. It’s to be found in various stock collections of photos, including one with the curious name of Unsplash where it’s available to be downloaded free of charge. It shows the face of a young man with a rather grim expression who appears to be dripping with sweat. Has he just run a marathon, or is he perhaps suffering from a fever?
You can see also this picture in an online advertisement put out by the upper case-challenged outfit called ‘effect doctors’ for a ‘Well Person Advanced’ blood test, though a little further down it’s called ‘Advanced Well Person Profile’. Same difference, I suppose. But this immediately raises a question: assuming you’ve not got a fever and are a well person, why do you need a blood test or profile? The answer is that you don’t.
Blood tests for healthy people
Anyway, Effect Doctors (that’s better) inform us that: ‘Our in-depth testing evaluates multiple blood biomarkers, to allow you take the first step in proactive healthcare; evaluate your physiological health with our comprehensive blood test panel and detailed medical report.’ Oh goody.
But hang on a minute! If this is just the first step, what other step or steps might you need? Let me guess: more tests and some vitamin drips, perhaps?
Then they get down to the nitty-gritty. The tests include a full blood count, kidney function, electrolyte levels, liver function, thyroid function, an inflammatory marker called CRP, bone markers (calcium, phosphate), uric acid, triglycerides, cholesterol, vitamin D, ferritin (iron stores marker), blood glucose level, HbA1c (a marker of blood glucose over the previous three months), etc. The more the better, eh? (Sigh.)
Anyway, if these benefits don’t have you perspiring with joyful anticipation, they are further spelt out and include the claim that you can ‘identify and monitor markers of illness early.’ Oh dear – you might have markers of illness!
This is where the whole dubious business of tests for ostensibly healthy, and especially for fit people, goes off the rails.
Now let me refer to an article in The British Medical Journal (BMJ) of 7 December 2024, titled: ‘Direct-to-consumer tests: emerging trends are cause for concern.’ Here’s a quote:
Targeting healthy populations creates a potentially lucrative market for test manufacturers. However, the health status of healthy people cannot be reliably measured with testing because, without clinical indications or context, there are no agreed protocols or reference intervals to interpret whether the results fall into a healthy or pathological range for the individual. Testing increases the chance of false-positives results and overdiagnosis.
Preying on the worried well
Another test Effect Doctors offer is ‘Tru Check Intelli Cancer Detection.’ What has Intelli got to do with it and what does it mean anyway? That aside, for a mere £1,500 it’s ‘the most effective and convenient diagnostic blood test available to distinguish up to seventy types of solid cancer tumours.’ Wow. Furthermore, ‘Tru Check’s tests have been validated across cohorts of over 40,000 patients,’ though no reference is given for this claim, and what do they mean by validated?
The BMJ comments on a similar test that is claimed to detect fifty types of cancer, rather than Tru Check’s seventy types. In either case, however, ‘They are inconsistent with current guidelines which are focussed on screening for only four cancers (breast, cervical, colon, and lung).’ The more the better, right? But the BMJ continues: ‘These tests are currently being marketed without any evidence of reduced mortality or extension of life expectancy…There is also a substantial risk of false positive results, leading to unnecessary diagnostic investigation with associated costs and anxiety.’ (My italics.)
Unwanted effects
I remember a tongue-in-cheek aphorism from my medical student days, that a normal patient is one who’s been under-investigated. But today, might this be true after all?
I don’t think so. Rather, in my unhumble opinion, if you feel well it’s better to stay away from doctors – or you might suffer some unwanted effects.
Text © Gabriel Symonds
Photo credit: Chrisopher Campbell on Unsplash