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Comment by Mountain_Skies | Hacker News Reader

It's unfortunate that it is not simple to get regular tests for vitamin and mineral deficiencies. The whole process seems to be stuck behind the doctor appointment firewall. This might be one of the reasons why Theranos was so readily believed. As the quantified self movement that gained popularity around the same time showed, there's an appetite in certain segments of the population for this type of testing and tracking but the process isn't very transparent and often expensive due to it being a profit center. Make it a simple yearly subscription where you can stop in at any time at a clinic like a CVS Minute Clinic, get a blood sample drawn, and then get your results a couple of hours later. Maybe a limit of once a month or once every other week depending on your needs. Only if something is out of standard range would you need to involve a doctor. It would also be good for your next annual checkup to have an entire year's worth of such data.

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I've often wondered if it would be economically feasible for blood donation banks to do this as a perk/incentive for giving blood.

Every 6 months or so, you donate blood and as part of the process you get run-of-the-mill bloodwork report emailed to you a few days later.

You'd have to make sure you weren't creating an incentive for sick people to donate blood just for the lab work, but otherwise it seems like it would be an excellent perk for donating blood.

That is an amazing idea.

I would definitely be more incentivized to give blood if it gave me a run down of various nutrients just from a curiosity point of view.

E.g. what are my selenium levels compared to the general population?

Depends, how much browser integration testing are you doing?

This was a good joke; good work must be recognized.

nice one.

Seems like that could easily work places with universal healthcare. Very little incentive to donate for free lab work when any medically necessary lab work would be done for free anyway.

And second that, would happily donate in exchange for curiousity-fulfilling bloodwork.

The obstacle isn’t the cost of labs, it’s the gatekeeping. Having to go to the doctor for basic bloodwork is still inconvenient even if it’s free.

But even in USA you can go and get blood test without a doctor.

The comment I replied to was suggesting doing these panels as part of donating blood as an added incentive, but was worried that people would intentionally donate while unhealthy in order to receive free lab work.

I said that isn't a problem places where medical lab work already has no cost, as no one would be incentivized to donate blood just to receive lab work.

Not sure where this got lost along the way since this is one of two comments effectively replying to the same misunderstanding.

I think the key is “medically necessary”. If I went to my doctor in Canada and said “can you run a panel of genetic tests” he’d say “no, that’s a waste of money because you don’t have any other risk factors”.

I’ve had a similar thought but the opposite conclusion on sick people.

I wonder if the business model could be a free or nearly free blood / genetic test for people. Each time you donate, you select either one genetic test panel or one blood test panel. The organization uses the money saved / earned from the blood donation to pay for the test. Possibly it also requires signing off on providing information to a research study as an additional revenue stream to pay for the testing / subsidize the creation of new panels.

I'm guessing this may not be economically feasible though. Additionally, you have the issue that people who can't afford health insurance would be literally selling their body for healthcare. Strictly speaking, it might be better than the alternative, but it's still not good that it's even necessary to consider something like this.

There are fairly silly exclusions to donating blood. I was recently (but apparently no longer, thanks to new rules?) blocked from donating blood because I spent too much time in Europe. Would be unfortunate to gate this care on such eligibility.

this seems like an example of a good solution being the enemy of the great one.

I don't think anyone is suggesting that simple bloodwork would be disallowed from other sources and this could be a good incentive.

You were probably blocked because of variant Creutzfeldt–Jakob disease (AKA human bovine spongiform encephalopathy AKA human mad cow disease).

The US recently removed the block for this on:

• people who were stationed with the military or lived on a base in Europe from 1980-1996, and

• people who lived in Europe for five years or more from 1980 to the present, except for two exceptions. Those are people who lived in Ireland or France for 5 years or more cumulatively from 1980-2001, and people who lived in the UK for 3 months or more cumulatively from 1980-1996.

Canada, New Zealand, Poland, Finland and the Czech Republic have similar rules, according to Wikipedia.

At least in Italy in part it works that way. You get some tests at every donation (like HIV) and some once a year (like colesterol) https://www.portaledeldono.it/donare/esami-al-donatore/ (link in italian)

When I'm feeling ill or need a test I call a friend of mine who is a nurse practitioner in another state. She has a ballpark idea of my current health, enough info to fit on an index card. Then she files a script with the pharmacy or writes me a prescription for a blood test. The whole thing is done in 5 minutes. In fact, the whole thing is done over iMessage.

Firewall is the perfect term. Everyone knows the industry is ripe to be turned upside down in the absense of a public option. What surprises me is that Walmart and Amazon still haven't attacked it head-on.

Amazon is starting to. See their recent announcements.

You can get blood tests without a prescription - or at least without a nurse friend, by just paying a fairly small fee and going to a local labcorp/quest diagnostics.

e.g. privatemdlabs.com (I'm not recommending this site - just giving it as an example. Though I have used it before without issue, there may be other companies providing better/more competitive services in this field)

This is true, but a full panel of tests will easily run you in the multiple hundreds of dollars.

This does exist now. Places like https://www.everlywell.com/ will test all sorts of things for you over the internet -- no doctor required.

Even beyond that in almost every state you can order your own labs via websites like OwnYourLabs, PrivateMDLabs, RequestATest, etc. OmegaQuant also offers an at home vitamin D test.

If you ask a hundred random people on the street about this, how many would know about it? Transparency is a huge problem here.

And I'd instantly not trust it because providing the service for a nominal fee would be so much less of a money printing scheme than providing the service for a nominal fee, but then once the fee had established trust using that transaction as a sales vector for all kinds of snake oil that's supposedly exactly what you need according to the results. Unfortunately there are many good reasons to burden the medical economy with all these stifling regulations. The quest for the least bad system is a permanent struggle.

I only see a test for each exact vitamin one by one. For instance Vitamin D is $49. Where is the full run-up?

Why not make it simple? I donate blood every 2 months. They tell me cholesterol and if I have c19 antibodies. Why not other important health indicators?

I can't donate blood, for fairly bogus reasons, this is true for a surprisingly large subset of the population

What's the reason? Maybe not share it but double check that the reason is still valid. The criteria changes pretty frequently. They always need more blood.

AFAIU you can’t donate blood if you’re gay. At least, I saw some segment on Anderson Cooper where he claimed that was the case.

>AFAIU you can’t donate blood if you’re gay. At least, I saw some segment on Anderson Cooper where he claimed that was the case.

That's not actually true. There are some restrictions if you're a man who has sex with men, but you're certainly not permanently barred from giving blood.

cf. https://nybloodcenter.org/donate-blood/become-donor/can-i-do...

So if you're in a committed, monogamous relationship where you have sex with your partner more than a couple of times a year, you're barred.

> There are some restrictions if you're a man who has sex with men

This is a weird way of phrasing it. More accurate would be: You may not donate if you are a man who has sex with men. The only way to donate is to 1) stop having sex with other men and 2) wait 3 months.

I'd say "you can't donate blood if you're gay" is a pretty close approximation.

>I'd say "you can't donate blood if you're gay" is a pretty close approximation.

As an approximation, yes. But that also includes bi-men, as well as women who have sex with bi men.

As such, your formulation also lacks precision, something you took me to task for (despite my link to actual data) in the previous sentence of your post.

Personally I think it's a dumb restriction given the advances in blood testing, but I don't run a blood donor program.

That said, those who deal with blood and blood products to be given to other humans tend to apply broad filters for donor acceptance. Note all the other restrictions in the the link I posted.

While extensive blood testing is the norm these days and the sensitivity of such testing is much better than it used to be, I imagine that being so picky about donors is much more about maintaining the integrity of the blood supply than being biased against any particular group -- even if it might seem that way.

Especially since the lack of screening/testing in the past caused a huge amount of suffering and death[0], including my own brother in-law, and through his exposure to tainted blood products, my sister as well.

Please note that such tragedies (with Hepatitis, HIV and other blood-borne diseases) are most certainly not the fault of donors.

Understanding the history[1] of these issues provides a lot of context (as it does for most things we do) for what we do today WRT the blood supply

[0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917149/

[1] https://www.ncbi.nlm.nih.gov/books/NBK232419/

If you have ever received chemo you’re barred for life, at least last time I checked.

I lived in the UK during the vCJD panic (colloquially mad cow disease), this bars me from giving blood or being an organ donor.

For a sense of scale a total of 177 people have died of vCJD, out of a UK population of approx 60,000,000

To be fair, I do understand that universally fatal, untreatable, undiagnosable, undetectable diseases with unknown incubation periods are scary, and I understand that blood donation is an amplification factor for blood borne diseases, hence the caution.

Well, but it was over 20, maybe over 30 years ago. I understand your anger.

Imagine, the UK would adapt this rule.

There's a reason medical tests aren't made easily accessible. The science of when regular testing something helps is complicated. If you test for things that are rare you might cause more harm than good by doing mass testing, because you might overwhelmingly treat people with false positive test results.

There's a lively debate around various cancer screening initiatives, which often don't have any good evidence that they overall do more good than harm. The same mechanisms are true for lots of other medical tests.

Ultimately a medical test should be treated like any other medical intervention: Only do it if you have scientific evidence that it helps the patient.

I agree with you on "detection tests" (not sure what a Dr would call them) - but checking for vitamin deficiencies would be more of a preventative type test, and everyone should have those probably once a year or every X years, but that would lower insurance profits, so they don't happen in the US anyway.

I usually use Ultalabtests.com to order my own blood work, but it pays to comparison shop even at an individual test level.

Being familiar with what tests I need to run and what the acceptable ranges are, there is literally no reason for me to go through the doctor appointment firewall anymore.

Around/after Thanksgiving, many of the online test mongers discount tests heavily, so it's not a bad idea to stock up for the year on lab work orders, as they don't expire.

Most online providers give you the choice of labs to use.

If you are in Arizona you can just go to Sonoraquest labs and order this test yourself.

Here you go https://www.pixel.labcorp.com/catalog

About every third ad i see on instagram is for some startup’s health measurement test.

I agree. I asked my doctor for blood tests but he refused as I didn’t have any symptoms.

The whole system is set up to fix things after they go wrong, not to prevent them in the first place.

I get an annual every year for around $150 and can request any test that I want from my doctor. I don't think this is something you need to test more often than that unless you have huge swings in your diet. Obviously if low levels of something are detected there are follow ups. I was actually low on vitamin d (by quite a lot) and started taking supplements. However, I do wish it was easier to get medical tests as you suggest without a doctors orders.

In a clinical setting when you know what you're looking for, blood tests are great. Randomly running panels on yourself, you'll have a hard time distinguishing signal from noise. Or even worse interference. Say, taking high doses of Biotin is known to interfere with many tests.

By all means, I'd rather have that data on myself than not. But I can see why the doctors wouldn't be too crazy about it.

I know, right; imagine if Theranos were actually legit. It'd be amazing. Something like that will probably come someday from some people who have more than just an idea and a zealous propaganda strategy. Current medicine, like a lot of fields, will probably be seen as incredibly immature in the next century.

Would make a great training data set too. Who knows what patterns we haven't found for lack of looking.

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