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c/bloodwork·posted 10 months ago by u/emil_agyeman

[PSA] ALT is not what most of this community thinks it is

Concerning Receipts ×5 Well Actually ×3 Slow Clap ×1

Something I noticed reading old threads that I have not seen said out loud.

The advice on ApoB in this community changed substantially around the start of last year, and nobody went back and updated the older posts. So depending on which thread the search engine hands you, you get two contradictory answers with the same confidence.

I have listed what I think the current consensus is below. Correct me — that is the point of posting it.

2,861 up / 70 down98% upvoted34 commentsid 17vgtl1 Oct 2025

34 comments

28 in this archive, depth 5

best — the order this archive was captured in

u/kenji_kimani0 points·10 months ago

Titration speed is a side-effect dial far more than an efficacy dial.

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u/sanne_novak161 points·10 months ago

baseline is the most important lipids measurement, you cannot collect it later

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u/iman_falk179 points·10 months ago

This is correct. ApoB is the better marker.

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u/gentle_correctionnice about it42 points·9 months ago·edited

This is correct.

Adding to this: ALT is doing more work than the comment implies.

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u/janek_ferrari27 points·9 months ago

A1c moves slowly, quarterly is plenty

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u/lipid_panel_larrybloodwork112 points·10 months ago

A1c moves slowly, quarterly is plenty

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u/nabila_bakken42 points·9 months ago

A1c moves slowly, quarterly is plenty

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/emil_agyemanOP22 points·9 months ago

eGFR noise on rapid loss is real. 20 week noise, 38 week trend. Do not panic at week 26.

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u/forest_plot_fionastats11 points·9 months ago

ApoB over LDL-C, that is the hierarchy

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u/coldchain_karencold chain5 points·9 months ago

redact identifying details from lab PDFs before posting

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u/jarno_karlsen83 points·9 months ago

post reference ranges with your numbers, units differ by country and lab

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u/freya_baptista99 points·9 months ago

the 2 month eGFR check is the routine

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u/heart_rate_bump39 points·9 months ago

ALT is where the fatty-liver story shows up first

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u/vito_chowdhury56 points·9 months ago

The evidence standard in c/vendorvetting gets called too strict about once a month, and every time, the thread ends with the complainant agreeing.

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u/amara_dziedzic19 points·9 months ago

Yeah, baseline matters more than any later number.

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[removed]21 points·9 months ago

[removed by moderator]

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u/tomas_kimani12 points·9 months ago·edited

the 21 month eGFR check is the routine

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u/iman_falk-30 points·9 months ago

Not convinced. The evidence does not support that reading.

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u/lipid_panel_larrybloodwork4 points·9 months ago

ApoB over LDL-C, that is the hierarchy

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u/bence_zamora10 points·9 months ago

Same lab both times?

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u/neha_rahimi4 points·9 months ago

Same lab both times?

Counter-anecdote: opposite result, same dose. Which mostly tells us the variance is huge.

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u/bac_water_banditreconstitution1 point·9 months ago

nobody here can tell you what a result means for you

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u/emil_agyemanOP4 points·9 months ago

Yeah, baseline matters more than any later number.

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About c/bloodwork

What to measure before you start, what to re-measure, and how to interpret movement without panicking. ApoB over LDL-C, HOMA-IR as a crude free tool, ALT and the fatty-liver story, eGFR noise during rapid loss, and the deficiencies that a 1,100-calorie appetite will hand you.

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