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Comment by dcow | Hacker News Reader

This (among other things) makes me wonder why we don't have better metrics and monitoring solutions for the human body. Your option is anecdotal self-diagnosis, or a full blood panel after seeing a doctor and convincing them that you need to be tested. It seems there's room for a product that monitors your health and sends you notifications when you need to address any metrics that are falling out of normal tolerances. Or at least something that helps you keep on top of preventative health visits. Holmes showed it can't really be invasive technology. I wonder if some sort of embedded blood monitoring device is feasible.

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Depending on your location, it is virtually impossible to get any real metrics.

A few years ago, inspired by some books I've read about nutrition, I tried to get a whole bloodwork done - and then another one after a few weeks of the new nutrition regime. The idea was to have a data-based approach to changing my life.

My doctor was less than helpful ('We only do full bloodwork if there is a medical indication, no I won't take your money'), and medical labs refused to do so because 'they only work with medical practitioners'. Apparently, in Germany, there is no way to get some data on my own goddamn body other than my height and my weight (things I can determine myself).

I would love to have a service where I send in a blood sample / have a blood sample taken, and get back a report, with all the values, on an easy to understand bar graph, with lower and upper bond of 'healthy'.

Startup idea, anyone?

"private" or "self-paid" lab blood tests are pretty common here, just across the border in Czech Republic, I'm surprised to find out they're unavailable in Germany, do you have to route every foreigner through a medical professional? Or is the catch that they won't do a "full" blood panel?

> Startup idea, anyone?

There are a few of these in the USA especially the Bay Area. Hell you can even pay for a full check up that even includes an MRI. Last checked the full service was like ~$5-6k and that includes pretty much everything you could want to know.

I've also been told you can get the same work done in Korea for a fraction of the price if your willing to take a vacation.

Half of the western world is overweight/obese (75%+ in the US), the vast majority of people are massively malnourished and under exercise

The market for that is very small, most of the things that kill are known, the solutions are known, there is nothing cost effective, no magic pill

Optimize for the basics, you have a long way to go before individual tests bring anything to the table. If you don't exercise vigorously 5+ times a week, walk 20k steps a day, skip alcohol, stop eating processed food, &c. no amount of vitamins will extend your life. It's like changing your tires every 5000km while skipping oil changes until the engine dies

My idea of basics would be like you can't out exercise your eating habits. Don't have a sedentary life. Supplements might not be ideal as opposed to sourcing everything from food but it goes a long way.

I'm not saying they key to good health is a big secret. I'm saying we're bad as a society or as human beings at objectively tracking this stuff and correcting negative trends often before it's too late. I've experimented with my body and nutrition a lot, with noticeable outcomes. You can't eat and know the next day that what you ate had too much refined sugar, or that it was organic and lacked toxins, just be how you feel. It takes weeks of not eating well before you notice anything and then months to years of the habit to gain enough weight to be obese. And some people eat like shit and feel great and don't get fat yet are wildly unhealthy inside. And some people are bigger than others and in pristine health. Diet is a huge part of health, yes, but there's more to health than diet... and how the heck does a person who's e.g. deficient in Vitamin D even know they are unless it's adversely affecting their mood. And even then how do they diagnose it and correct it when doctors are ~~bribed~~ encouraged with gifts to prescribe designer drugs for every problem.

My argument is that this information about your body should be more accessible so people are empowered to learn it and act on it of their own volition. If that were the case I bet we'd see less crack pop science surrounding diets and nutrition. Anyway your car analogy doesn't really hold. I can plug a $100 device into my car and diagnose what's wrong and read any data I want. It will tell me when I need to change the oil. I can look at the tires and see if they've worn past the safe level and replace them as needed. I can't do that with my body. The only consumer devices available are blood glucose and keytone test strips. There's no consumer "full blood panel" what would solve the problem the person I responded to shared. And consider women going through pregnancy, it's very very easy to be missing some key nutrients. It's common practice to supplement with pre-natals for the entire fertile phase of a woman's life. All because a lot of changes happen to your body that are hard to understand subjectively, so just spray and pray with vitamins and iron.

I'm sure this is at some level by design by the AMA. If people had access to low cost blood tests then we'd be undercutting a huge component of the medical industrial complex and the AMA does shady shit to keep doctor salaries high enough to justify all the schooling and certification fees.

Also where did you get that 75% number? Anecdotally it's not accurate. Obesity is higher than it should be but 3 of every 4 people are not obese even by the > 30 BMI metric.

So, again, why would more open access to baseline metabolic metrics be a bad thing?

Final related point: I establish care when I move to a new location but I have never had a medical provider do something like actively reach out and e.g. schedule me for yearly physicals. The closest thing is people reaching out to administer flu and covid shots. When I was younger I had to have physicals to participate in sports, but as an adult it's like I'm supposed to only reach out to doctors when a problem occurs. It's all reactionary. There's not a good pattern for establishing regular care and maintaining a preventative, nutritional, etc. dialog with a health professional. How do I bill "preventative nutritional consultation" to my insurance provider? We can do it for dental hygiene, why not nutritional and metabolic? The modern state of nutrition feels like pseudo science "neighborhood" gossip. We hated fat. Then we went organic. Then we disliked processed foods. Paleo. Then we hated carbs. Now that's not cool anymore either. When in reality it's probably all of the above.

My wife has thyroid problems and they're not diet related (at least we've been told). The whole process of advocating for her health has been exhausting. The resolution of her "case" was not driven by people we were paying to advise us and keep track of things. It was driven by us. We had to make sure medical records showed up in the right spots. We had to make sure appointment scheduling didn't get dropped. We had to reach out to make sure follow up visits and analysis were completed as advised in previous visits directly from the health professionals themselves. I've noticed differences by location where we've lived. It's better where we are now. But it's still very very reactive. Oh you got pregnant? Why didn't you have a conversation with us about starting prenatals? Did we check your TSH levels and make sure you were in a good zone? Shit like that is infuriating... (we did both for the record, but imagine the feeling if you answered no, which I would suspect is all too common).

> So, again, why would more open access to baseline metabolic metrics be a bad thing?

not a bad thing if you considered it in isolation for a single individual. But for an entire society? The cost of doing so might be quite high, even if there's an economy of scale efficiency improvement for such large amount of testing/diagnostics.

The recommended regime of diet, exercise and such, are a solution for most people that doesn't require you to know your own metric (and the example of pregnancy is a non-sequitur because this isn't a normal state of affairs, and when pregnant people can easily choose to do such bloodwork to measure their metrics).

So it’s “normal” for essentially half of all people to do regular bloodwork for significant phases of their lives. And old people and sex workers and there are more examples than I think you realize where people have blood drawn on the regular. I’m not sure you really have the scale dialed in. Either way, my example is most certainly a non-sequitur, we agree, because it’s an example, not a conclusion (8

To be clear, I’m advocating for a solution that’s more like doing a full metabolic panel every year, so you can catch people with Vitamin D deficiency. And/or an improved approach/UX surrounding managing patient case flows. I mean tracking tasks through workflow states is a very solved problem. To my knowledge hospitals don’t employ any such methodology.

I have never digged into the matter, but the closest existing thing which resembles your idea is that apparently, in Japan, there are toilets which do automatic testing and reporting. That seems like a neat idea because it does not require any kind of invasive procedure, but it is likely also a bit limited in what it can test for.

You don’t have any wellness centers or clinics around you that offer blood tests? A full panel costs $80–100 but its not expensive for something you can do every few months to make sure you’re in good health. No need to convince a doctor.

In certain states the law forbids the unwashed masses from having their own blood tested (a doctor must order the blood test). Land of the free!

See (7) and (8) of https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Ch...

Blood panels are expensive and laborious to do with any frequency. Your body does a reasonably good job of monitoring and remediation on its own.

> Blood panels are expensive and laborious to do with any frequency

I believe their implication is that there should be some engineering effort to reduce the expense and labor

You're faced with a fundamental problem of getting the blood out, though, which is always invasive and labor intensive. Or worse, you could embed a semi-permanent medical implant of some kind which would be obscenely expensive.

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