Is it Worth Getting an Annual Physical Exam?

Is it Worth Getting an Annual Physical Exam?
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What are the risks and benefits of getting a comprehensive annual physical exam and routine blood testing?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The model of getting an annual physical exam dates back nearly a century in American medicine, but recently, many health authorities “have all agreed that routine annual checkups for healthy adults should be abandoned.” Yet, the majority of the public still expects not only “a comprehensive annual physical exam [but] extensive routine [blood] testing.”

“Given the gap between patients’ enthusiasm and [the new] guidelines’ skepticism about annual [physicals], what are physicians to do? First, we must educate patients about preventive practices of proven [versus] unproven benefit.” For example, “[t]he only [routine] blood test currently recommended by the USPSTF [the official preventive medicine guidelines-setting body] is cholesterol.”

The reason “why many physicians continue to perform annual examinations of patients’ hearts, lungs, abdomens, and even reflexes, and continue to order some of [those] tests that have been proven ineffectual or even harmful” is because otherwise, the patient might leave unsatisfied with the visit. “Evidence suggests that the more…physical and laboratory examinations they perform, the better patients feel.” So, they’re like “placebo…manoeuvres.”

“But rather than performing unnecessary [or worse] exams…and…tests, perhaps physicians should spend some of the time saved by telling their patients why they are not” going to just go through the motions, like some witch doctor.

“Most important, we need to educate ourselves about the dangers of overdiagnosis. There will always remain a small possibility that our exam…might detect some silent, potentially deadly cancer or aneurysm [or something]. Unfortunately for our patients, these serendipitous, life-saving events are much less common than the false-positive findings that lead to invasive and potentially life-threatening tests.”

This Cleveland Clinic doc shared a story about his own father, who went in for a “checkup.” Can’t hurt, right? The doctor thought he felt what might have been an “aortic aneurism;” so, he “ordered an abdominal ultrasound.” Can’t hurt, right? Aorta was fine, but hmm, something looked “suspicious” on his pancreas; so, “a CT scan” was ordered. That can hurt: lots of radiation. But thankfully, his pancreas looked fine. But hey—what’s that on his liver? Oh, for goodness sake. Looked like cancer, which made a certain amount of sense, having worked in the chemical industry. So, realizing how ineffective the treatments were for liver cancer, he realized he was going to die.

The daughter was not ready to give up on him, though; “convinced him to see a specialist.” Maybe, if they could cut it out, he could live at least a few more years. But first, they had to do a biopsy. And, the good news was, no cancer. The bad news, though, it was a benign mass of blood vessels; and so, when they stuck a needle in it, “he almost bled to death.” Ten units of blood is like all you have. Pain, and so morphine, and so urinary retention, and so catheter; yet, thankfully, no infection. Just a bill for $50,000.

“The frustrating thing” is that the whole horrible sequence wasn’t like malpractice or anything; every step logically led to the next. “The only way to have prevented this [life-threatening] outcome would have been to dispense with [that] initial physical exam”—the one that couldn’t hurt, right?

“Why, then, do we continue to examine healthy patients?” Well, first of all, it’s because “we get paid to do it.” His dad’s initial doc only got a hundred bucks or so, but just think of all that “downstream revenue” for the hospital and all the specialists. Overdiagnosis is big business.

Yes: “Too many patients bear the costs and harms of unneeded tests and procedures,” but without annual check-ups, we doctors would miss out on all those opportunities for “open communication and interpersonal continuity.” To which one physician replied: Look, if you’ve deluded yourself into thinking you’re doing more good than harm, if you want communication, why not just take your patients out to lunch or something?

“Of course, such lunches should fairly and ethically be preceded by an informed consent discussion that allows prospective diners to understand the risk that they may be [patronized to], and may well receive unnecessary and injurious…interventions as a consequence of that grilled cheese and soup”—particularly, I would add, if you’re feeding your patients grilled cheese, having already chalked up your first such unnecessary and injurious act.

Please consider volunteering to help out on the site.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The model of getting an annual physical exam dates back nearly a century in American medicine, but recently, many health authorities “have all agreed that routine annual checkups for healthy adults should be abandoned.” Yet, the majority of the public still expects not only “a comprehensive annual physical exam [but] extensive routine [blood] testing.”

“Given the gap between patients’ enthusiasm and [the new] guidelines’ skepticism about annual [physicals], what are physicians to do? First, we must educate patients about preventive practices of proven [versus] unproven benefit.” For example, “[t]he only [routine] blood test currently recommended by the USPSTF [the official preventive medicine guidelines-setting body] is cholesterol.”

The reason “why many physicians continue to perform annual examinations of patients’ hearts, lungs, abdomens, and even reflexes, and continue to order some of [those] tests that have been proven ineffectual or even harmful” is because otherwise, the patient might leave unsatisfied with the visit. “Evidence suggests that the more…physical and laboratory examinations they perform, the better patients feel.” So, they’re like “placebo…manoeuvres.”

“But rather than performing unnecessary [or worse] exams…and…tests, perhaps physicians should spend some of the time saved by telling their patients why they are not” going to just go through the motions, like some witch doctor.

“Most important, we need to educate ourselves about the dangers of overdiagnosis. There will always remain a small possibility that our exam…might detect some silent, potentially deadly cancer or aneurysm [or something]. Unfortunately for our patients, these serendipitous, life-saving events are much less common than the false-positive findings that lead to invasive and potentially life-threatening tests.”

This Cleveland Clinic doc shared a story about his own father, who went in for a “checkup.” Can’t hurt, right? The doctor thought he felt what might have been an “aortic aneurism;” so, he “ordered an abdominal ultrasound.” Can’t hurt, right? Aorta was fine, but hmm, something looked “suspicious” on his pancreas; so, “a CT scan” was ordered. That can hurt: lots of radiation. But thankfully, his pancreas looked fine. But hey—what’s that on his liver? Oh, for goodness sake. Looked like cancer, which made a certain amount of sense, having worked in the chemical industry. So, realizing how ineffective the treatments were for liver cancer, he realized he was going to die.

The daughter was not ready to give up on him, though; “convinced him to see a specialist.” Maybe, if they could cut it out, he could live at least a few more years. But first, they had to do a biopsy. And, the good news was, no cancer. The bad news, though, it was a benign mass of blood vessels; and so, when they stuck a needle in it, “he almost bled to death.” Ten units of blood is like all you have. Pain, and so morphine, and so urinary retention, and so catheter; yet, thankfully, no infection. Just a bill for $50,000.

“The frustrating thing” is that the whole horrible sequence wasn’t like malpractice or anything; every step logically led to the next. “The only way to have prevented this [life-threatening] outcome would have been to dispense with [that] initial physical exam”—the one that couldn’t hurt, right?

“Why, then, do we continue to examine healthy patients?” Well, first of all, it’s because “we get paid to do it.” His dad’s initial doc only got a hundred bucks or so, but just think of all that “downstream revenue” for the hospital and all the specialists. Overdiagnosis is big business.

Yes: “Too many patients bear the costs and harms of unneeded tests and procedures,” but without annual check-ups, we doctors would miss out on all those opportunities for “open communication and interpersonal continuity.” To which one physician replied: Look, if you’ve deluded yourself into thinking you’re doing more good than harm, if you want communication, why not just take your patients out to lunch or something?

“Of course, such lunches should fairly and ethically be preceded by an informed consent discussion that allows prospective diners to understand the risk that they may be [patronized to], and may well receive unnecessary and injurious…interventions as a consequence of that grilled cheese and soup”—particularly, I would add, if you’re feeding your patients grilled cheese, having already chalked up your first such unnecessary and injurious act.

Please consider volunteering to help out on the site.

Motion graphics by Avocado Video

Doctor's Note

So, if you don’t have any symptoms or issues, should you even go in for an annual check-up? That was the subject of my last video, Is it Worth Getting Annual Health Check-Ups?

Should All Children Have their Cholesterol Checked too? Check out the video, and find out!

I tend to stumble across these peripheral issues, and get dragged down the various rabbit holes. For example, I’ve got a whole series of videos planned on various diagnostic tests, such as mammograms. I don’t want to get too far off the nutrition, but whenever I learn something new and interesting—particularly if there are conflicts of interest trying to muddy the waters, I feel the need to try to share to help set the record straight.

If you haven’t yet, you can subscribe to my videos for free by clicking here.

93 responses to “Is it Worth Getting an Annual Physical Exam?

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  1. Thank you for the amazing job! I was wondering if this applies to annual pap smears. After an abnormal result and HPV confirmation, not from strains 16 or 18, I was told I needed a colposcopy and then a cone biopsy, which I consider a major procedure. Should I just wait and see if it resolves by itself? I wonder if this exams every year are a good idea…




    0
    1. Claudia I don’t believe your case is what Dr. Greger is talking about. First off you have a positive test. If you don’t trust your MD get a second opinion.

      But Dr. Greger would never recommend you should “wait and see.” He isn’t practicing medicine on this website. Good luck.




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      1. I think in Claudia’s Case that it would apply to her. Most people with HPV and abnormal cells are asymptomatic. I found out I had abnormal cells through an annual PAP exam. I had no symptoms and still have none. With almost 80% of the United State’s population having had some form of HPV at some point in their lives, I would not wait to feel symptoms before going for that specific annual exam. If you wait until you have symptoms than you waited until you had late stage cancer. Now routine wellness exams is a different topic. But PAP exams are something I would not skip. My doctor did not over treat me. Just bringing me in for my regular exams and monitoring it closer to make sure they catch it if something does happen. When I have normal results again that will be a good sign.




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    2. Claudia – if you follow closely the video from the beginning, you will see that Dr. Greger is talking about asymptomatic individuals. People with no symptoms. An abnormal test result is not asymptomatic. A confirmed clinical result is not something that would apply here in this video topic.




      6
      1. But she probably would be asymptomatic. Most people with HPV and abnormal cells are. The virus lays dormant and symptomless in most individuals.




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  2. I’ve seen many a time when well intended MD’s go about chasing wild gooses all for naught. Especially in a persons later years… A wise old neuro surgeon once told me, when you hear the sound of hoof beats, don’t go looking for zebras…
    mitch




    3
    1. My now 96 year old dad had written in his will as well as telling every family members that he does not want surgery or put on respirator or do anything to prolong his life when it “comes to the time to leave planet earth” and he can’t no longer makes decision for himself. He is now relatively healthy thanks to partially the nutrition (although he is very lazy to eat) but I mainly attribute to the many supplements that he takes.

      Some states such as Oregon define what kind of procedures and how much can be spent on terminal ill or old patients, based on statistical data.




      4
  3. About the quote from the Dr G’s above Doctor’s Note: ” I don’t want to get too far off the nutrition, but whenever I learn something new and interesting—particularly if there are conflicts of interest trying to muddy the waters, I feel the need to try to share to help set the record straight.”

    I usually get the most value out of the nutrition related findings, but I do appreciate these tangential discussions, especially when conflicts of interest and bias are involved in the popular perceptions that most people get from the media. Dr John McDougall is another good doctor who also shares his opinion on controversial tangential subjects.

    Thank you Dr G and all involved in producing this valuable website!




    14
    1. Last night I looked to see how my favorite doctors, in Santa Rosa, are faring with the fires. Dr McDougall and his wife, daughter and grandchildren evacuated safely, but lost their home.

      Dr Lim and his family also had to evacuate, but I don’t know if they lost their home.

      Dr Klaper has a short video on his Facebook page. He and his wife are fine and the fire stopped about a mile north of their home.




      14
      1. Rebecca – where did you find this info and updates? I’d like to follow along. Yesterday I got an email from McDougall stating that they’d evacuated but did not know about their home. So sad to hear of this. How can we reach out? (I realize it may be premature right now, but we can think about this maybe?)




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  4. You all need to realize that the legal profession rarely litigates for over treatment – but loves to litigate for under treatment. What a shame the best answer we have to avoid a malpractice action is to not do an annual physical. It really says a lot about the state of medical care in the USA.




    5
    1. Company such as Google has a symptom search using research and statistical data to diagnose potential health issue based on your symptoms. This is no different from describing your symptoms to a doctor who got his knowledge from medical school, but could be biased or making wrong diagnosis because of his/her incompetence.

      I have not verified the quality thoroughly but I have used several times and it looks pretty good. Just go to Google search and type your symptoms and a number of medical articles will show up. Google does not make the diagnosis itself but they are done by medical articles. Of course those medical articles can be bad if they are written by bad doctors but at least it will get filtered out based on search results.

      https://www.theverge.com/2016/6/20/11978338/google-symptom-search-app-web-md-health-doctor




      1
      1. On the subject of Computer generated diagnoses, when I was working in the field of “Artificial Intelligence” back in the 1990’s, I remember reading about a software system based on artificial intelligence techniques designed for doctors to use to diagnose patients based on their symptoms and blood tests. I haven’t followed that technology since I am not in the medical field (I’m a theoretical mathematician), but I imagine it has come a long way since those early days. Maybe some doctors can weigh in here and let us know if doctors now use software tools such as these to do there diagnoses, behind the curtain ;-) I would think that most doctors would oppose tools like this because it would put a lot of them out of a job! But I certainly believe that the technology is there! Computers running sophisticated software can now easily beat grandmaster chess players! (See link below:)

        http://www.extremetech.com/extreme/196554-a-new-computer-chess-champion-is-crowned-and-the-continued-demise-of-human-grandmasters




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        1. Agree, Hal. I am sure savvy IT hackers could redirect theirs skills to more useful services. Or even IBM could devise a comprehensive diagnostic protocol like the IBM chess champion that would easily outsmart Dr House et al, thank God now off the air after deluding viewers for years with unreality medicine.
          I also think this could be done to our millennia old judicial system involving biased jurors, opinionated judges and legions of greedy lawyers ….frequently finding obvious criminals not guilty and condemning innocents….all at enormous costs to society and creating huge case backlogs.
          But alas, powerful vested legal and medical interests in cahoots with our legislators would block any attempts at reforms that would send many overpaid professionals into productive jobs at realistic lower salaries.




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        2. WFPB-Hal, the Google symptom checker does not diagnose any diseases but simply use the power of its search engine to find medical articles that talk about those diseases and they will list first the ones that have the most search hit. So it’s kind of a heuristic learning engine based on knowledge.

          On the other hand, the AI used by IBM Deep Blue will get the knowledge but can also make deduction based on those knowledge and resemble more a human mind. Did you work on Deep Blue? I saw a piece on 60 minutes and was very impressed.

          One of the things that Deep Blue is working on now is to analyze the genetic data and symptoms of a cancer patient to come up with the best personalized treatments for every cancer patient .

          http://www.washingtonpost.com/sf/national/2015/06/27/watsons-next-feat-taking-on-cancer/?utm_term=.4eb487d716a6




          1
          1. That’s a very interesting article about IBM’s next generation of Artificial Intelligence after “Deep Blue”, called “Watson”. I never actually worked on the Deep Blue project, but was more involved with “Artificial Neural Networks” which was another form of machine learning where a computer is programmed to mimic how the human brain works and digitally simulates an analog system. See this link for a discussion of ANN’s:

            https://en.wikipedia.org/wiki/Artificial_neural_network

            My personal opinion is that we are already at the beginning of a new age where computers will be replacing many “mental” jobs, just like during the Industrial Age of the 1800’s, machines replaced many manual labor jobs. The big resistance will be from those whose high-paying jobs will be lost! Medical diagnostics is really ripe for being replaced by a computer running artificial intelligence software like the IBM Watson system. Here’s a quote from the article on IBM’s Watson:

            “A 2013 paper by economists at the University of Oxford calculated the probability of 702 occupations being automated or “roboticized” out of existence and found that a startling 47 percent of American jobs — from paralegals to taxi drivers — could disappear in coming years. Similar research by MIT business professors Erik Brynjolfsson and Andrew McAfee has shown that this trend may be accelerating and that we are at the dawn of a “second machine age.”




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            1. WFPB-Hal, I am fascinated with the new AI technologies. I cannot wait to see self driving car because I am tired of driving and sit in traffic.

              As for robots and machines that can replace man, we obviously cannot stop the wheel of progress but I am a little bit concerned about the social consequences. You and me and our kids will have no problem adapting because we have the education and skills but how about the regular Joe? Not everyone can go to college and even when you go to college, the future is also gloomed these days because there are fewer jobs that require even more skills.

              Regarding computer replacing doctors then I am all for it because a machine cannot be biased and cannot be bribed by big pharma. So if a machine analyzes the DNA and comes up with the best personalized chemo then it’s best because not all cancer can be treated with the same chemo. But what I am concerned about is if a machine learns from biased textbooks and knowledge then it’s garbage in garbage out. You already know that I have different opinions about certain things despite perhaps 80% of the researches may say the other way. But let’s pick a subject that we can all agree. I was watching TV this afternoon when they give a “hint” on how to lose weight. So it’s based on calorie counting such as you can eat so many Skittles for snack because it has so much calories. Geez, it’s candy and sugar and no matter how much you eat, you will gain weight. You can eat 10 avocados which have more calories and you won’t gain one ounce of weight. What will happen if Deep Blue is taught with this kind of knowledge of calorie counting? It will give advice to lose weight by eating no avocado but only eat 5 skittles.




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              1. @Jerry I think you’ll find this TED talk very interesting. It describes how artificial intelligence systems have the propensity to amplify whatever biases are inherent to the system or decision-making process that they’re mimicking:

                Cathy O’Neil: The era of blind faith in big data must end
                https://go.ted.com/Cyfb

                Learn more about watching TED Talks on all of your favorite platforms: https://www.ted.com/about/programs-initiatives/ted-talks/ways-to-get-ted-talks




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                1. Ryan, I just watch the Ted Talk video. Yeah you are right, AI can use algorithm and data that are biased. For instance if supercomputers were around 400 BC when it was discovered that the earth is round, it would keep insisting that the earth is flat because that’s what the astronomers had said for thousand of years. If supercomputers will govern this earth then there will be no progress because all (obsolete) data would point to the other direction.

                  The only good thing about supercomputers and AI is that they are consistently biased and cannot be bought. So if you have doctors that blindly prescribe drugs based on symptoms then you may as well replace them with a robot and save money.

                  The following TED Talks video is also interesting.

                  https://www.ted.com/talks/tricia_wang_the_human_insights_missing_from_big_data




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      2. Interesting. I wonder if 20 years ago I would have thought to look up symptoms of a very aggressive form of thyroid cancer. My nodule was first diagnosed in a physical exam and then biopsied. I’ve heard the story again and again from others. Of course my thyroid was subsequently removed and had not spread. But it was not a good cancer to leave hanging around.




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    1. Agree, Gregory, we need a sensible national health care system like Taiwan’s, patterned after the best in the world at 100% coverage with direct access via personal electronic ID cards and costing 1/3 of US health care. Most civilized nations use NHS thereby cutting out the enormous cost of unneeded insurance middlemen.
      Again, powerful lobbyists colluding with legislators would make it an uphill battle for President Trump.




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      1. Herman. I don’t think the insurance middlemen are the problem. They have a strong financial interest in driving costs down and keeping people healthy (so they don’t make clais on their health insurance). The problem is the drug companies, hospitals and other service providers (doctors, lab testing companies, imaging companies). Individuals have no negotiating power versus these organisation.

        In countries with NHS though, you have a single (or a few large) purchaser of pharmaceuticals, hospital services, physicain care, imaging etc. They can negotiate really good prices. That’s why we see all the rhetoric about “socialised medicine£ (shock, horror) and the alleged superiority of the private system – the people who make superprofits from providing these things know that if a NHS is introduced, they are likely to have to alight from the gravy train. They havehe same attitude to HMOs which attempt to control use of unnecessary and overpriced drugs and procedures.

        There is for example some evidence that patients in private for profit hospitals, compared to those in not for profit hospitals, have both higher costs and higher mortality. I could speculate that the reason for this is that people in the private system are much more likely to be overprescribed and overserviced (because that is how hospitals and service providers make their money). This is dangerous both for our wallets and our health.
        https://www.ncbi.nlm.nih.gov/pubmed/25437212




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        1. Gentlemen:

          The United States already has one of the largest single payer, national health programs called Medicare. Anyone can figure out the result of extending those services to the entire population using public information. I suspect the entire GDP is not big enough to cover the potential liability.

          I think we need to move beyond politics and rhetoric. There is tremendous knowledge and innovation in the US industry. We need a creative way forward that taps into that energy.




          0
          1. In order to lower cost someone is going to have to accept a smaller piece of the highly profitable health care pie. Who will that be?
            I think an important part of the resolution is what is advocated by Dr Greger and a growing number of others is lifestyle change. That is how you reduce the size of the pie and it’s many pieces.




            3
  5. Hello Claudia,
    I am a family doctor with a private practice in lifestyle medicine, and also a volunteer moderator for this website. Thank you for your question. While I agree with WFPBRunner that Dr. G. is not intending to practice medicine on this website (nor am I), I also think that screening exams, including physical exams and Pap smears, are exactly what Dr. G is talking about in this video — because your Pap smear results could cause you to get an unnecessary procedure. However a Pap smear could also save your life!

    As to whether or not you should proceed to getting a colposcopy, I don’t have enough information to advise you. It depends on your age, and also on exactly what HPV strains were found on your Pap smear. Strains 16 and 18 are responsible for about 70% of all cases of cervical cancer — but that’s not 100%.

    The recommendations for how we treat abnormal Pap smears have been changing every 2 to 5 years for about the past 15 years. Here is a helpful link by the American College of Obstetricians and Gynecologists (ACOG): https://www.acog.org/Patients/FAQs/Abnormal-Cervical-Cancer-Screening-Test-Results

    Assuming that your doctor is a knowledgeable gynecologist or internist or family doctor who is up to date on the latest recommendations, you would be wise to follow their advice. However, if you have any doubts, you should get a second opinion. I feel strongly that you should not just “wait and see” without any further input from a doctor you trust.

    It would be a little unusual for you to be told you need a cone biopsy before you even get the results of your colposcopy. Are you sure that the plan is to get both, or did your doctor just mention a cone biopsy as a possibility? Note that a colposcopy is a pretty benign procedure: it’s just a magnified view of your cervix — but also usually includes doing one or more biopsies, which involves only a tiny bit of your cervix. On the other hand, you are correct that a cone biopsy is a more major procedure.

    I hope this helps.
    Dr. Jon
    PhysicianAssistedWellness.com
    Volunteer moderator for NutritionFacts.org




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    1. Hello Dr. Jon,

      Thank you very much for your thoughtful and useful message. I agree with you! And with Dr. Greger. I do medical exams including pap smears every year, and although I’m healthy and everything has been normal so far, this last pap smear had me thinking how sometimes the way medicine is practiced leads to unnecessary procedures and anxiety.

      I forgot to mention: I’m 37 and the strain was high risk but not 16 or 18, or one that gives warts either. I was vaccinated against the HPV and don’t have any of the risk factors to get the virus, so as my doctor said, I’m the living example of doing everything right and still getting HPV. I already had the colposcopy with a biopsy and the results were normal. Nevertheless, the gynecologist advised to have the cone biopsy done and I think that’s too invasive given the normal results of the biopsy. I thought it would be better to wait and have another pap smear later to see if the virus is gone then. Oh, and I’m vegan ☺️

      Thank you very much.

      Best wishes,




      3
  6. I understand and agree with everything that Dr G said. But in my case, annual (or bi-annual) visit to the doctor and blood test are beneficial for me and my wife, because we know how to interpret the results and know when to “ignore” the doctor recommendation. But for the average person then I don’t know. On one hand, I know that frequent visit to the doctor will likely lead to overdiagnosis and over prescription, but on the other hand, our life expectancy did go up (although it’s declining lately). I understand that the ideal solution is to use the money spent on doctor visit and prescription to educate people about nutrition, and we will get more bang for the buck and we won’t have an overrun in healthcare budget. But this won’t happen for a long time or will never happen. At least, I see that younger people are more aware of nutrition than the older generation, at least from my limited observation of my kids and their friends and the videos on Youtube.




    3
    1. Dear Jerry:

      I believe that Dr. Greger overstated his case. His entire site is dedicated to preventive “medicine”. The question to ask Dr. Greger is what is the role of medicine and MD’s in preventive medicine?

      When I watch the videos, I often update a preventive medicine framework that I developed. One of the columns consists of biomarkers of potential problems that Dr. Greger identifies in his videos, obvious examples are height to waist ratio, more obscure ones include inflammation markers such as CRP and homocysteine levels in blood, and even teleomeres length. All of these are identified by Dr. Greger.

      So, there is a role for tests beyond lipids. Maybe Dr. Greger should address this? What is the ideal preventive test benchmark? Should it be personalized? How frequent the feedback?

      My belief is that there is a need to accelerate change in standard care faster based on discoveries and to give the patient more power over his own information along with tools to interpret results. Doctors need to be educated too and become more like coaches.




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  7. The idea that a physical exam should be conducted yearly may indeed be nonsensical. However, a physical exam with detailed blood work including a lipid panel, HBA1C, and complete blood count has been, in my experience, useful for seeing the consequences of a change in dietary regime. To illustrate this, if not for such tests I wouldn’t have objectively determined that I am particularly sensitive to dietary cholesterol and/or saturated fats; my cholesterol hit 314 when I was tricked into thinking eggs, coconuts, and dark chocolate bars were healthy. When I dumped those foods and replaced them with lots of beans, my cholesterol dropped to around 185. But if you do use lab work to evaluate dietary change, you should adhere to such a change for 4 months beforehand because red blood cells have a generation span of 3-4 months, and it’s necessary to allow a full generation to pass for an accurate HBA1C test.




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    1. Benzo – I had great blood work results when I, too, changed to a WFPB diet. I’d never been a junk food eater – always a “healthy” diet with lots of animal protein and fresh/cooked vegetables, whole grains, etc. I followed the meat and bone broth advocate Sally Fallon’s dietary recommendations and my blood work went to heck in a handbag. My cholesterol skyrocketed, I developed gout, my blood pressure rose to high range (145/85), my thyroid numbers moved in the wrong direction, I gained 30 lbs. and was officially in the overweight range. I felt completely uncomfortable. And frightened.
      I changed to a WFPB, no added oil diet and my weight returned to a 21BMI, energy skyrocketed, Blood pressure not only returned to normal (back to 120/75) but then continued to normalize to 109/67. My gout is gone and my cholesterol back below 200 into safe range.
      Luckily, I can get a full panel blood test at a yearly health fair where I live to monitor my situation without having to go to a physician. In most (but not all) states one can buy a blood panel test on line. I use the yearly test to keep an eye on how my numbers are doing and otherwise don’t go to a physician unless I’ve got a specific need – like an infection, etc. Interestingly, however, my 25 year physician recently dropped me because I’d not come in to see her for over 5 years. Her office manager said I could return but would have to enter as a new patient and get a full exam to do so. She said I should have come in for something over the years. I was shocked that I was told that I HAD to come to my doctor and use services despite feeling perfectly healthy. This reminds me of the story that Dr. Esselstyn shares in his book “Prevent and Reverse Heart Disease”. When he asked one of his colleagues, a cardiologist, why he doesn’t refer his patients for nutritional counseling for their heart disease, the cardiologist’s reply was “Have you seen my billables?”. The cardiologist billed insurance companies better than $500K/year. The Doc was living the good life at the expense of his patients.
      Now, . . having said that, let me also say that I am guessing that this cardiologist is probably still paying off his gigantic school loans that he is saddled with. The medical system in this country is akin to a giant wheel that rolls along almost of its own volition – and we are all caught up in it. It takes tremendous work to slow or alter the course of a giant bus careening along with no one really in the drivers seat.




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  8. N=1. If I hadn’t had a blood test with high TSH and cholesterol I wouldn’t have known I was low in iodine. (I had to figure that out on my own with the help of the internets.)




    1
  9. Not to get more off topic but…..

    What about annual flu shots? Good idea? Bad idea? Is the immune system bolstered by a plane based diet enough?




    1
    1. Bad in my opinion, but it depends on each person and I don’t want to decide for everyone. From what I read, flu vaccine only addresses one strain of flu and there are many strains.

      In my personal case including my family, we had absolutely not a simple cold let alone flu ever after we took a mushroom cocktail supplement (on top of eating fresh mushroom).




      3
      1. Hi Jerry this is Dr. Sozanski, PhD in Natural Medicine in Atlanta GA, and Moderator with Nutritionfacts and this is also a comment for WJB. Wow, pertaining questions. I searched the database and only found one article which obliquely addresses the question. It was shown that Chlorella has the capability to enhance the IgA antibody production. IgA antibody is charge of protecting of pathogens active in the mucous membranes, such as mouth, throat, gut and nose (or rather, it reversed its deficiency). https://nutritionfacts.org/video/preserving-athlete-immunity-with-chlorella-2/
        Also, as mushrooms are the richest source of vitamin D on the planet and promoters of IgA, I use and recommend them abundantly. Here is a video that would delight you https://nutritionfacts.org/video/boosting-immunity-while-reducing-inflammation/ if you are not aware of it already.
        In addition, Amla, which I have been using for cholesterol lowering properties also proves to have similar IgA enhancing capabilities.
        Finally, flu shot or not, I strongly believe anyone would benefit from proactively building their immune system, particularly IgA ,via a focused diet.
        Best regards, Daniela




        4
        1. Daniela, besides containing rich nutrients, mushroom has the following properties:

          – contain beta glucan which modulates the immune system and increase production of B and T lymphocytes, which are the crucial immune cells that help control our response to pathogens, viruses, toxins and other substances that cause diseases.

          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684115/

          – contains a powerful antioxidant called ergothioneine that helps lower bodywide inflammation

          Interesting that mushroom or fungus is a single cell but can do so much.

          Chlorella is even more special because it is loaded with nutrients. It’s a single cell algae but somehow it is loaded with more nutrients than regular mushroom.

          https://wellnessmama.com/2719/chlorella-uses-benefits/

          Certain types of mushroom have more medicinal properties than others. We are familiar with Shiitake, Cremini, oyster, etc. but a new kid in the block is turkey tail. The following man is an expert on mushroom and you may be interested to look him up.

          http://bastyr.edu/news/general-news/2012/11/fda-approves-bastyr-turkey-tail-trial-cancer-patients

          http://www.fungi.com/

          https://www.youtube.com/watch?v=pXHDoROh2hA




          0
        1. I use RM-10 from Garden of Life and I believe that most if not all of their supplements are vegans. I read that cordyceps is good except that it is expensive and it is basically a rare mushroom that is prone to fake stuff. You have to buy from a good source such as from Japan. Cordyceps is originally found in deep forest but they are grown domestically these days. But if I have cancer then I will buy real cordyceps no matter how much it costs. I used Turkey Tail mushroom supplement for just one time but stopped because of cost. For now since I am healthy, I used RM-10 for maintenance but trust me, it works. Myself and my family have no cold, no flu, not a single cough, for years. And I literally rescue my Dad from his deathbed when he came down with some kind of flu and was lying on the bed immobilized and could not get up. He is now 96 year old and as young and vigorous as he can be for a 96 year old.




          0
    2. When I was in the Navy back in 1960, everyone was given a flu shot, no questions asked, no exceptions. The fact that I had an allergy to egg albumin was never considered, even though the flu vaccine is cultured in an egg medium. A few minutes after the shot, I noticed something peculiar. My hands were starting to swell and my face was getting red. I didn’t know what was happening but immediately went to Sick Bay to have it checked.

      The doctor who saw me gave me a shot of what was evidently epinephrine to quell the anaphylaxis. He told me that if I hadn’t been seen soon, I could have been dead in an hour. Even to this day, my health provider, Kaiser Permanente, calls me to tell me to get the vaccine, even though my medical record says that I’m allergic to eggs.




      4
    3. WJB: This question has come up a few times recently. I’m sure people who eat a WFPB diet are less likely to get sick, but I have seen no evidence that says we are immune. WFPB eating usually lowers risk for diseases. It doesn’t usually guarantee anything. So, it is worth getting the shot if we (maybe!) have lower risk? Following is the information I’ve shared recently:

      Following is a link to the Cochrane report on the flu vaccination effectiveness. The Cochrane institute is an independent organization that reviews studies across the world on various topics to try to draw some conclusions. To my knowledge, this is a well respected and truly independent group. This report may help you make a decision. http://www.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults

      Some highlights:

      1) The preventive effect of parenteral inactivated influenza vaccine on healthy adults is small: at least 40 people would need vaccination to avoid one ILI (influenza-like illness) case (95% confidence interval (CI) 26 to 128) and 71 people would need vaccination to prevent one case of influenza (95% CI 64 to 80). Vaccination shows no appreciable effect on working days lost or hospitalization.

      2) On the other hand, they didn’t find any harm with it.

      3) And the studies were not all that good quality-wise: The real impact of biases could not be determined for about 70% of the included studies (e.g. insufficient reporting details, very different scores among the items evaluated). About 20% of the included studies (mainly cohorts) had a high risk of bias. Just under 10% had good methodological quality.

      My bottom line from this is that the data really isn’t there one way or the other. If I were around vulnerable people, I’d get the shot to error on the side of caution.

      Beyond that, it’s not clear to me whether getting the shot is a good idea or not. I suffer from major indecision and angst on this topic. In addition to the lack of good data, there are a several key ethical issues which pull me both ways. For example: a) Does paying for the flu shot support an industry which is preying on people’s fears and not really protecting them? b) From what I’ve read, most of the flu shots available are developed using eggs. I don’t want to contribute to an industry that causes a giant amount of suffering, especially when the chance of helping myself may be small. c) On the other hand, am I putting children and seniors at risk since they are more likely to experience significant harm (maybe even death) from getting the flu, and I could be a carrier?

      Then there are also competing “point of principles”: a) I should stand my ground on something I believe in and not succumb to peer/family/doctor pressures when I know the data is just not there. b) I should pick and choose my battles. Is this issue really worth bucking the trend for?

      For the record: I’m all for vaccinations in general. I am in no way encouraging people to worry about important vaccinations (such as the commonly recommended childhood vaccines) which have proven benefits. The issue I have is when the benefit is questionable and the harms real/known.

      What do you think?




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      1. Hi Thea

        Thanks so much for your detailed response!

        I am really on the fence with it as there seems no way to prove that the flu shot added protection or it didn’t. If you get the flu shot and still get the flu then the typical response from the doctor is “well the flu shot doesn’t protect against all strains” or “it could have been much worse had you not got the shot.”

        Some years I get the shot and some years I do not. Some years I get the flu and some years I do not — there is no correlation that shows I get the flu only when I skip the flu shot.

        I will take a close look at the paper you cited. My employer heavily encourages people to get the flu shot and makes it very convenient to do so (after all, they want to avoid a bunch of sick employees unable to produce ;) )




        2
        1. Thanks Julie. I did mention the eggs in my comment. I agree that the use of eggs is something to consider when making a decision.

          Did you know that they have a method for making flu shots that does not involve eggs? That option may become more available in the future, removing that ethical point from the discussion. For more info: http://www.medscape.com/viewarticle/777773 Note that it’s also free of thimerosal for those who are concerned about that ingredient too.




          1
        1. I say the same thing about you Dr. HemoDynamic!

          FYI: I’m not really back so much as making the occasional appearance — especially if I have a a post already made up to answer a question. :-)




          4
    4. Hi WJB, this is Dr. Sozanski, PhD in Natural Medicine in Atlanta GA, and Moderator with Nutritionfacts. I am posting this twice, for you and Jerry. Wow, pertaining questions. I searched the database and only found one article which obliquely addresses the question. It was shown that Chlorella has the capability to enhance the IgA antibody production. IgA antibody is charge of protecting of pathogens active in the mucous membranes, such as mouth, throat, gut and nose (or rather, it reversed its deficiency). https://nutritionfacts.org/video/preserving-athlete-immunity-with-chlorella-2/
      Also, as mushrooms are the richest source of vitamin D on the planet and promoters of IgA, I use and recommend them abundantly. Here is a video that would delight you https://nutritionfacts.org/video/boosting-immunity-while-reducing-inflammation/ if you are not aware of it already.
      In addition, Amla, which I have been using for cholesterol lowering properties also proves to have similar IgA enhancing capabilities.
      Finally, flu shot or not, I strongly believe anyone would benefit from proactively building their immune system, particularly IgA ,via a focused diet.
      Best regards, Daniela




      2
  10. I used to work in a lab, and was able to get blood tests done for free. It was educational, as I could see the results of dietary changes reflected in my blood tests, showing me that I was doing something right. I watched my total cholesterol plummet to 120 mg/dL, based on a radical change in diet. When I was eating the standard American high fat, high cholesterol diet, it was 250. Even then I had no symptoms of heart disease, no diabetes, no high blood pressure, no shortness of breath, etc.

    My doctor said that I was in excellent health. He didn’t think that my 250 cholesterol was that big a problem. A little high, he said, but nothing to worry about. But I was fairly young at the time, 30 years old. Had I stayed on that diet, I would paid the price as I got older. Fortunately, I was able to correct it, but I didn’t do so until some 15 years later. Had I waited much longer, my chickens (beef, lamb, pork, etc.) would have come home to roost, probably as I was running uphill in 10 kilometer race! See “NATHAN PRITIKIN DIET FOR RUNNERS,” in which he has a chapter entitled “Run and Die on the American Diet.”

    In it, he cites Dr. Paul Thompson, who “reported data from Rhode Island from 1975 to 1980. For each sedentary man 30 to 64 years of age who experienced sudden death, there were seven joggers. Seven jogging sudden deaths to one sedentary sudden death! Dr., Thompson writes: ‘Exercise contributes to sudden death,’ and [Pritikin adds]: only on the American diet.” [My emphasis]




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  11. It may be a problem that comes from beliefs. The metaphor that man is a machine is believed by many people. Cars need 36000 mile inspections they say. But people need 1 year inspections because they are a different machine. So if you believe that people are machines, then you may also believe that people also need scheduled regular maintenance to live longer.




    0
  12. A friend of mine was diagnosed with colon cancer followed by a rash of colonoscopies by others in that friends circle. How many of us have confidence in our own bio feedback (which may or may not be backed up by our diet & exercise experiences)? Academic discussion of generalities may help reduce anxiety, but is not a replacement for perception of certainty… even if it is faith based.

    For every anecdote of unnecessary (or even harmful) checkup, there will be another that saved the life in the nick of time! Concerns at a personal level can not be averaged out in population statistics. At a personal level, we need 100% certain answer, which we believe we get from regular checkups.




    2
    1. I am not sure that you will get a “100% certain answer” from regular checkups and asociated testing. False negative results and false positive results are common in various areas of testing eg
      “In this retrospective review of 150 consecutive patients with CRC, less than 10% of our patients were detected by screening program
      False negative or miss rate of colonic investigations was 8% which has serious implications for symptomatic patients and may lead to diagnosis at an advanced stage and poorer outcomes
      Barium enema is associated with a high miss rate and should not be recommended for evaluating symptomatic patients”
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290010/




      1
  13. While I agree with the basic premise of this video, I second the endorsement of selective blood testing, particularly as one transitions from the standard American diet (SAD) to a whole foods plant-based diet. I’ve found the annual blood work helpful to fine tune my diet and exercise regime and also find daily monitoring of my blood pressure a strong motivator to keep on task when I get tempted to slide on either diet or exercise. It would be interesting to think about whether some blood tests might also be useful for maintenance for folks who are eating vegan (e.g., B12, Vitamin D, essential fatty acid profile), particularly for older folks to ensure they are getting enough key nutrients.




    2
  14. While I can appreciate Dr. Greger’s caution about unnecessary, unproven testing, the annual exam could be a valuable and cost-effective use of time if directed towards educating the patient about preventative, lifestyle changes to prevent disease, and remediate risk factors/unhealthy behaviors before they lead to more serious outcomes.

    Given the epidemics of obesity & diabetes we face, and the prevalence of heart disease and cancer, our top killers, and the common occurrence of gut-related issues and autoimmune conditions — all largely avoidable and modifiable by preventive lifestyle factors like diet, movement, stress reduction — the decision to reduce primary care oversight and guidance to reactive interventions after illness strikes would be regrettable.




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    1. Cathy – I would so love it if a primary care appointment were used as you suggest – to educate about lifestyle changes. The last time I was in for a physical with my doctor she did a breast exam, blood pressure, and a pap. Didn’t weigh me, didn’t check my heart, lungs, pulse, etc. Very short and sweet. After I got dressed the only diet related question she asked me is if I were drinking enough milk. In my mid-40’s at the time I’d not drunk milk since I was a teen due to a severe lactose intolerance (which I didn’t know what it was at the time as this was before we labeled it – I just knew that my gut was in severe pain after consuming milk). When I told her I didn’t drink milk I told I should be doing otherwise.
      What is so sad is that my doctor – who is a wonderful person – really believed she was advising me well to drink 3 glasses of milk/day. She was worried about osteoporosis. In my mid-60’s now, and after a lifetime of no milk drinking (nor yogurt or cheese), I have no osteopenia or osteoporosis. I share my story here for others who worry that giving up dairy will somehow harm their health. I realize that I am N=1, but we have to begin somewhere don’t we? (and, btw, I take care of my bones by making sure I have sufficient D3 and weight bearing exercise as it is the tugging of the tendons and ligaments on the bone that cause the bone to respond by increasing bone denisity).




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      1. As a plant-based nutrition & culinary educator I have joined up with a physician who does exactly that. You need to find one who practices lifestyle preventive medicine & if they’re plant-based…even better.




        1
  15. As a primary care nurse who participates in yearly screening procedures with patients I had to step away and think about this information. It was startling for me to see the evidence and I was thrown into much doubt and confusion- and that is a good thing for me because it forces me to think rather than to just go along with what is always done.

    So to make a long story short, I came up with what works for me personally. I will use screening only as it applies to my risk factors and for the goals that I set for my health. As I progress on my WFPBD, I want to see the results in my lab work and blood pressure because I have goals for where I want the values to be.

    As to others, I have seen previously undetected serious disease picked up in a routine screening, but that has been very rare. I have also seen signs of early disease and this can provide an opportunity for just the kind of education we want give, like a WFPBD (if the person is beyond the pre-contemplatative phase of change theory). It seems however, that most people come in for a health assessment based on need. So I imagine that might be the way it goes for a long time ahead.

    Excellent video with compelling issues for thought.

    A proud monthly supporter of Nutritionfacts.org




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  16. IMHO getting an annual physical is like taking your car to the dealer they are going to find something that needs to be done.The dealer service department is the main cash cow of the dealer so they recommend things that aren’t really needed.As most everyone knows our health system is profit driven after all they have to pay for those expensive high tech machines.Don’t get me wrong i love those machines as they helped save my life when i had my heart attack but i think a lot of the test are just so they can have a good revenue stream. You can get all the test and exams but if you don’t have a healthy diet you’re not going to have a healthy life : )




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    1. I’m in the middle on this. On the one hand, I stopped going to my cardiologist once per year for a check up because I had no symptoms of a problem after an atrial flutter ablation (not the same as an atrial fibrillation procedure) in 2014. I’m glad I had the procedure since I have had no recurrence of symptoms and I take no medications, unusual for a 70 y.o. in the US. On the other hand. I like to get blood work every so often to make sure things are going smoothly. Thanks to blood work, I discovered not long ago that my iron was way to high, as was my B12. My wife, on the other hand, who resists going, discovered her D was way too low and her iron was a bit low. All of these problems have been corrected with suitable dietary/supplement changes. But we both know what’s up and are able to reject recommendations of the doctors we see.




      0
        1. They can tell from an EKG. Atrial flutter is “regularly irregular” (irregular pattern repeats), a-fib “irregularly irregular”.




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  17. Annual physical exam, maybe not. A well-chosen annual blood workup has been a good thing for me. I need to know if my cholesterol levels are rising so I can evaluate diet changes. Like someone earlier, I went down the coconut, organ meat, and bone broth path once with very poor results. I also needed to know that I was hyperparathyroid, something that wouldn’t have been diagnosed without a history of consistently high calcium levels. I needed to know my vitamin D3 and B12 levels. A blood test is a low-risk annual check that can give high value information.

    The tests that have lead me down rabbit holes have been x-rays or CT scans that were initiated by an acute physical problem. Had a scan to diagnose a kidney stone, they freaked over a liver spot that turned out to be a hemangioma that I have likely had since birth. I ended up having more radiation exposure to diagnose something that does not need treatment. I had my knees x-rayed because of an injury, and they noticed a spot on my femur. Another scan exposing me to radiation to diagnose it as a benign fibrous dysplasia that my mother remembered that I’ve had since I was ten. Both things could have been something bad, and I understand why the doctors wanted more tests, but the real result was that I was exposed to more risk from the tests than I was from the actual conditions. I’ve been walking this earth for nearly 60 years with both conditions and simply didn’t need to know about them. I had the sense of falling down the rabbit hole into medical wonderland both times. Yet it could have been an important early diagnosis. I honestly don’t know the best response to these things, though I’m personally inclined to refuse the follow-up tests in the future and take my chances. I am especially leery of my local medical network, which is very insistent on the next test (and the next bill).




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    1. Hi Anne, this is Dr. Sozanski, PhD in Natural Medicine and Moderator with Nutritionfacts.org. I enjoyed your account and your insistence to track some measurements that you felt represented potential issues. That is proactive. That is awareness. That is awesome.
      On your CT scan and other tests comments, I appreciate one clear and present example of the point Dr. Greger makes in his video. Best regards, Daniela




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  18. Keep the good stuff coming and the patients out of my office.

    I want more motivated human beings, not more chronically sick patients. I don’t mean to sound callus but I get way more enjoyment watching people learn the lifestyle changes that allow them to become healthy and happy rather than giving them false hope by giving them a pill.




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  19. Our health insurance provider offers an incentive for annual physicals in the form of several hundred dollars in our HSA which is hard to ignore. Fortunately my doctor is unlikely to over diagnose or over prescribe.




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  20. I have a story similar to the doc’s father in the video:

    Annual checkup -> abnormal liver enzymes -> liver sonogram -> suspicion of cancer -> CAT scan -> MRI -> scintillation scan -> endoscopic liver biopsy -> percutaneous biopsy -> diagnosis of benign hemangioma (prevalence: 7.4% of population!). Meanwhile, I am terrified, my family is terrified. (It’s not fun to believe that you may have a terminal illness.) Cost: ~$12,000.

    Abnormal liver enzymes can be caused by something as common as tylenol in susceptible people. Percutaneous biopsies of liver hemangiomas are generally contraindicated, because they can cause rupture of the delicate blood vessels and cause massive, sometimes fatal, internal bleeding.

    I think doctors, with heroic intentions, often want to “rule out” a sexy and dramatic worst case scenario, however rare this scenario actually might be. Ruling out with certainty is often a lengthy process, during which the patient hears only the message that the improbable is entirely possible.




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  21. In a society plagued by epidemics of obesity and a range of inflammatory processes resulting in conditions such as diabetes, atherosclerosis, high blood pressure, arthritis and dementia the role of prevention is to reduce this burden.

    I agree, it is not well met by current medical practice. In fact, doctors are often in need of help for themselves.

    So, the question is, what is the role of medicine in effecting the life-style changes needed to improve the outcomes?

    And, what tests are best for monitoring progress towards improvement?

    That is what we need to move forward.




    1
    1. Hi Tom: this is Dr. Sozanski, PhD Natural Medicine, Atlanta, GA and Moderator for Nutritionfacts. org. Your question struck a note dear to my heart. You are making a great point. I personally believe world is changing and there are more and more physicians turning towards Functional medicine, a clever approach to health that allows them to use necessary tests, supplementation, diet and if necessary medication and other means. I find this to be the best of two worlds, so I am hopeful in a good outcome of this effort. The tests would be carefully chosen, outsourced to independent cost effective labs and definitely helpful in arriving to a diagnosis. You’ve got to use the advantage of technology, in an effective way. Best regards, Daniela




      1
  22. Hi Dr. Greger – I would like to add to this mix. I would certainly prefer not to go to the Dr. every year. However, two things happen if I do not. One is that if more than a year elapses between visits, the Dr. is hesitant to treat me for anything should something arise. The second thing which happens is that if you wait too long to be seen, the office requires that a person be seen as a new patient when they come back again. They may or may not take you back. If they do, it will be more costly and time consuming. These two factors are not just what my Dr. does; this has been my experience across the board. So just to play nice, I go in every year.




    1
    1. Hi this is Dr. Sozanski, PhD Natural Medicine and Moderator at Nutritionfacts. This is more of a personal note, but yes, I believe the system is built in such ways as to encourage annual visits and make lapses more painful. We are getting back to the video, that alludes to the reasons. Best regards, Daniela




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  23. Can high blood pressure “always” be corrected with diet? Or beta blockers is a must?

    I hear once you get started on beta blockers and high blood pressure you can stop.




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  24. This is off-topic but may be of interest.

    This Medscape commentary explains why we should not be confused about nutrition and health by sensational media reports of findings from observational studies. It specifically mentions the recent PURE study which was represented as showing that crabs are unhealthy and fats are healthy. However, the same argument can also be applied to the other recent PURE study which appeared to show that lowsalt consumption is unhealthy.

    The Medscape article does not mention that both studies were authored by teams led by investigators from McMaster University. McMaster University is a partner of the Canadian dairy industry. Dairy products are high in both saturated fat and salt.
    http://www.medscape.com/viewarticle/886723?src=wnl_edit_tpal&uac=129079FG#vp_1




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  25. Steven, I don’t know about “always,” but I was on beta blockers for several years for high blood pressure, and I was able to come off them. I went on a strict plant-based diet and lost 70 pounds. I was able to go off bp meds after about 50 pounds. Modest changes in diet did not work, and it took several months of consistent diet change, but I got there. In fact, my doctor reduced my dosage and took me off the drugs without prompting because my bp was dropping. I used Dr. Fuhrman’s Eat to Live diet.

    I was originally an obese vegetarian who ate a lot of unprocessed food and lots of vegetables. The eggs, dairy, sugar, added salt, and olive oil had to go before I regained my health. On the other hand, maybe all the vegetables kept me from having a heart attack before I came to my senses.

    It can be done!




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  26. This is off the subject but I just read this article: https://www.thehealthyhomeeconomist.com/what-the-health/. This lady claims that a vegan diet is untested and unhealthy. She claims that we need to eat pastured eggs, meat, and dairy to be healthy and says the Blue Zones populations all ate meat, dairy, and eggs. So now I’m confused and feeling like if I keep going on my WFPB diet I will ruin my health. She has a list of references a mile long. Can someone at this website help?




    0
    1. ka.rinne: It would take too much time to try to debunk every crazy article out there. Let me give you a few thoughts instead.

      First, there is only one diet that has ever been clinically proven to reverse heart disease: a low fat whole plant food based diet. When I say reverse heart disease, I’m not talking about lowering risk of heart attack. I’m talking about actually opening up arteries. (There’s at least one video here on NutritionFacts which shows the before and after x-rays.) Why would you want to listen to people who push a diet that can’t do that?

      Second, it is true that the blue zone diets were not vegan. However, they were largely a diet of whole plant foods, with some marginal animal products thrown in. Consider that one of the longest lived, healthiest populations on the planet was the traditional Okinawans, one of the 4 blue zone cultures. They have so many people who live to 100 years old that the community has a group party where the birthday girls and boys *march* down the street… What did these super healthy people eat? Their diet was 85% carbs, 6% fat and 9% protein. 69% of the diet was sweet potatoes. About 4% of their calories came from animal products. http://nutritionfacts.org/video/the-okinawa-diet-living-to-100/ I’m not saying you need to exactly imitate the Okinawans to be healthy. I’m trying to drive home the point that animal products are not necessary for most humans. We have a ton of science which tells us that the Okinawans were healthy in spite of that tiny amount of animal consumption — not because of it.

      Finally, note that having a list of references “a mile long” is not the same thing as having a *valid* list of references. There are some people who have taken the time to debunk the work of “cholesterol denialists” and “saturated fat apologists”. They fact check the references and find that those references often fail to back up the claims being made. While not addressing the article you linked to, here are some examples of those types of reviews:
      >>> On The Big Fat Surprise Part 1: https://thescienceofnutrition.wordpress.com/2014/08/10/the-big-fat-surprise-a-critical-review-part-1/
      >>> Part 2: https://thescienceofnutrition.wordpress.com/2014/06/30/the-big-fat-surprise-a-critical-review-part-2/
      >>> On Good Calories Bad Calories and a whole bunch of others: https://thescienceofnutrition.wordpress.com/2014/04/21/fat-in-the-diet-and-mortality-from-heart-disease-a-plagiaristic-note/
      >>> Or check out the work on the following site for a deep dive into the issues: http://www.plantpositive.come

      I didn’t read the article you linked to, but I did skim parts of it. For example, the list of bullet points about what she claims are problems with vegan diets is a set of un-truths and completely misleading information. In addition, she failed to back up any of it. Like you, I noticed that there was a long list of references at the bottom — not a single one of which were linked to any specific claims in her article! Anyone can take a list of references. It doesn’t mean anything. If you did that for a paper at school, without numbers linking points in your text to specific references, I expect you would be given a failed grade.

      I hope this helps to put the issues into perspective.




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  27. I think this is being made needlessly complicated. I am a family doctor in the UK. I discourage my patients from seeing me or having tests without good reasons, they often will do better concentrating on a healthy lifestyle. If they do go down the medical route though there are well established and well thought out algorithms which we all have to follow, these are evidence based.
    The person with CIN needs to just follow the algorithm, it’s not perfect but there isn’t a credible alternative. If you have been told you need a colposcopy go to the appointments!
    I personally virtually never go to see any of my colleagues, but that is a personal decision. I think there is too much uncertainty about health to be dogmatic. I also follow a virtually vegan diet, probably with a similar proportion of animal products to the Okinawan traditional population.
    Our government wants to pull money out of the private sector to help finance our health care system, that is understandable but they don’t seem to have realised health care is a bottomless pit for money. What is needed is good public health initiatives. They don’t really think us GPs add much to the mix. We see most of the patients most of the time but that is just an inconvenient fact to be ignored.
    I recommend nutritionfacts.org to a large number of my patients, and I often suggest they read about Blue Zones too.
    We all owe a debt of gratitude to Dr Greger for his amazing videos and the resources at nutritionfacts.org. Science and medicine are full of uncertainty but he is remarkable in retaining some clarity. Thank you, Dr Greger.
    Dr Kevin Curry, MRCP, MRCGP, UK General Practitioner, Barnstaple, North Devon.




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  28. At my annual checkup it was discovered I have chronic kidney disease stage 3b even though no symptoms of ckd stage 3b were present. Without the Comprehensive Metabolic Panel, my ckd would have continued to be undiagnosed. Maybe the information in the video could address an individual’s age and the value of a yearly physical exam and lab work.




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  29. This past January, I made the switch from an M.D. to N.D. (Naturopathic doctor), my hope was to find a doctor who would work with me on preventive measures. I eat a plant-based diet. He ordered an extensive round of blood tests, and the results found I’ve been suffering from some inflammatory issues, brought on by a gluten-intolerance and fructose malabsorption. I had experienced varying degrees of GERD, weight gain, sleep loss, and a number of upper respiratory infections. Once, I learned of my particular issues, I made the change to exclude gluten and most fruits (for some reason I can eat melons) from my diet. My GERD disappeared, I’ve lost 15 lbs, my cholesterol dropped 80 points (from 250 down to 170). I would never have known about this, without this blood test and the help from my doctor, who I see every 3 to 4 months, to help monitor my progress. I don’t feel the tests he’s ordered for me, as being overly excessive, especially when compared to my former M.D., who basically Googled things on the Internet, and made his recommendations from that source.




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