what does homa-ir actually tell you that fasting insulin does not
#bloodwork 2026-05-11
Monday50 messages10 participantstimes are UTC
Highlights from this day
- tarpit_tam — and for the direction of travel, FLOW is the renal outcome trial and it came out protective 15:09
- tarpit_tam — correct. one is a population outcome over years, the other is your creatinine on a tuesday 15:22
- sharps_comedy — two year arc, same lab, all fasting 15:37
- tarpit_tam — and this is that question answered eighteen months later, which is the only timescale that ever works 16:07
if you only get one thing, get a fasting insulin. it is the one that becomes impossible later
[edited]if a result frightens you, that is a conversation with a clinician. we will help you read it, we will not tell you it is fine
my potassium came back weird and the retest was normal, whats that about
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apob is the better marker and it is harder to get. i track both because i can only get one reliably
not a chat question
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a small egfr dip is often dehydration. rehydrate and retest before you panic
update from 5 months ago: a1c down, apob unchanged, and i am genuinely annoyed about the apob
tsh moved slightly, is that a known thing
most of the lipid improvement in my panel tracked the weight, not the drug
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eGFR went from 92 to 81 in the first two months. should i be worried
a small early dip is a known haemodynamic pattern with several drug classes. it is not automatically damage
what matters is the slope over a year, not one step
and creatinine moves with muscle mass and hydration. you have just changed both
i had not thought about the muscle part
creatinine-based eGFR is an estimate that assumes an average body. lose 20kg and some of that assumption breaks
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is there a better test
cystatin C based eGFR does not care about muscle. it is not standard everywhere and it costs more
asking for it
and for the direction of travel, FLOW is the renal outcome trial and it came out protective
which does not mean your dip is nothing. it means the dip is not the story
correct. one is a population outcome over years, the other is your creatinine on a tuesday
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how does anyone keep track of all these numbers
one row per week. weight and waist, and lab columns where i have them
weights-and-labs-2y.csv
1 file · 41 KB · not retained in the public archive
the weekly weight column is what makes the lab rows readable. rate of loss explains half of them
two year arc, same lab, all fasting
start m3 m12 m24
HbA1c % 6.4 6.1 5.4 5.3
fasting ins 22 14 6.8 6.1
HOMA-IR 6.1 3.7 1.5 1.3
apoB g/L 1.28 1.19 0.82 0.79
ALT U/L 63 44 21 19
eGFR 92 81 88 90
weight kg 131 121 97 94🔥21🙌7
the eGFR came back
it usually does. that is the shape people should expect and almost nobody is shown
the insulin column is the one i would frame and hang up
archive lookup: two earlier conversations from this member in #bloodwork — 2024-09-14 baseline panel, 2025-01-08 month three follow up. linked to this one.
i asked about that eGFR dip in january last year and got told to wait. that was the right advice
and this is that question answered eighteen months later, which is the only timescale that ever works
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different question — my potassium came back high, what do i do
you ring whoever ordered the test. today, not after you have read the archive
a high potassium is not a chat topic and we are not going to guess whether it was a squeezed sample
haemolysis is the most common reason for a spurious one, but the person who can tell you is the one holding your record
ok, calling now
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come back and tell us. it always helps somebody
back — repeat draw was normal. they said the first tube had probably been knocked about
most common answer, and still the right thing to have checked
two loops closed in one day. good channel
occasionally we are useful
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i pay privately for fasting insulin because nobody will order it for me otherwise
lab error maybe
what should i get at baseline before i start
if your glucose is in mg/dL the divisor is 405. if it is mmol/L it is 22.5
the FLOW result is why my nephrologist changed her position on this entirely
get fasting insulin at baseline. you cannot go back and get it once you have started
unrelated but nobody here is reading your bloods as a clinician. we are reading them as people who have had a lot of bloods, for what its worth
retest it
thats the 90 day thing
my b12 is borderline, supplementing or eating differently
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