While watching the baseball World Series the other night (what an incredible game 7, by the way! I’m not the kind of person who typically gets that drawn into watching sports, but that really was a game for the ages!), I saw a commercial that got my attention: Serena Williams, the legendary Tennis player, was advertising GLP1 agonist medication (translation: weight loss jabs such as Ozempic or Wegovy) for a company named “Ro.”
Recent headlines about a new study from Consumer Reports have created a scare about protein powders. For example, CBS has a typically alarmist opening paragraph:
Let’s leave aside the pros and cons of protein powder for this post and just grant for the moment that:
a) people can get all the protein they need from a well balanced diet and don’t need protein powders, and b) some people, for a variety of reasons, find benefit to including protein powders in their diets.
For those who fall into this later category, should they stop using protein powders simply for fear of lead contamination?
In my last post, I fleshed out some of the logical arguments for why overtesting (the practice of ordering lots of tests, “just to check”) can sometimes backfire on patients and lead to worse outcomes. Today I’m going to provide brief vignettes of two actual patients I cared for during my residency training to better illustrate the point.
Many people assume that the lack of pro-active testing for every possible problem in medicine is simply done as a cost savings measure. Patients will sometimes complain to me that their insurance won’t cover a periodic full-body MRI, or a routine stress test, or blood testing in the absence of any symptoms for this disease or that. And there is some validity to this critique: it’s certainly true that insurers like to spend as little money as possible on patients. But to be fair, there is another side to the argument, which is that – contrary to what many assume – testing for problems that aren’t apparent can sometimes in fact be harmful.
This is a difficult topic to grasp, so I’m going to break this post down into two parts. Today, I will outline some of the logic behind why tests can sometimes create more problems than they prevent. In next week’s post, I will give a few actual anecdotes from my career that demonstrate the point.
How could it possibly be that ordering tests to screen for health problems can be harmful?
The researchers in the study performed several separate lines of research and published them all in one paper. First, using advanced lab techniques, they studied humans and determined the following:
I don’t think I’ve mentioned it before, but one of my favorite health podcasts is called “Zoe.” Zoe is a British-American company that offers a service of personalized testing: they mail you a kit so you can submit a blood specimen and a stool specimen, as well as wear a continuous glucose monitor for a few weeks. Then they analyze all of this data and come up with personalized nutrition recommendations for you that are supposed to best sync with your own biology. I have no idea whether this works well or not, but the podcast that they use to market their product often features great conversations with legitimate scientific experts.
At any rate, I enjoyed their latest episode, which covers a subject near and dear to my heart: how to sleep better. Included in the episode are some of the topics I hammer home a lot (such as having a steady wakeup time, getting morning sunlight, and developing good beliefs around sleep), as well as some new tips and tricks that I was not previously familiar with. If you’d like to give the full episode a go, you can listen to it here:
