Vitamin D, adiposity, and a volume-of-distribution problem
Reduced intake is a plausible mechanism for deficiency. Reduced absorption is not, and the two are conflated in most of the advice.
Liver
Hepatic steatosis, transaminases, and the MASH trial programme.
Reading HbA1c in the presence of anaemia
The alternatives with shorter windows, what they measure, and why they are rarely ordered.
Which results are findings and which are consequences of the weight loss
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
Measuring more frequently generates more flags and not more information
The argument for a baseline panel is that it makes every subsequent result interpretable. The argument against frequent monitoring is that noise accumulates faster than…
What the trials monitored, and what that implies about routine practice
What the pivotal programmes measured and how often, which is a more defensible template than most published monitoring schedules.
Vitamin D, adiposity, and a volume-of-distribution problem
What the trials measured, which in the case of micronutrients is very little.
What the upper limit of normal for ALT should be, and why it is not
What the renal and hepatic outcome programmes actually measured, and over what duration.
What the trials monitored, and what that implies about routine practice
The argument for a baseline panel is that it makes every subsequent result interpretable. The argument against frequent monitoring is that noise accumulates faster than…
What a low result means when intake has halved
Micronutrient guidance for this drug class is borrowed almost entirely from post-bariatric surveillance, where the anatomy is different and the deficiency mechanisms are not…
Rapid weight loss moves eight analytes for reasons that have nothing to do with the drug
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
Which results should be repeated before they are investigated
What the pivotal programmes measured and how often, which is a more defensible template than most published monitoring schedules.
Vitamin D, adiposity, and a volume-of-distribution problem
Reduced intake is a plausible mechanism for deficiency. Reduced absorption is not, and the two are conflated in most of the advice.
Falling ferritin is not always falling iron
Three different explanations for the same abnormal number, and how to tell them apart.
Micronutrient monitoring: which panel, how often, and on whose evidence
A monitoring schedule requires evidence about incidence. For this population, that evidence does not exist.
Which results are findings and which are consequences of the weight loss
The estimated glomerular filtration rate is calculated from creatinine, creatinine comes from muscle, and muscle mass is falling. The arithmetic is unforgiving.
Which results are findings and which are consequences of the weight loss
Three different explanations for the same abnormal number, and how to tell them apart.
What the outcome trials measured in the kidney
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.
Thiamine and the vomiting patient
What the trials measured, which in the case of micronutrients is very little.
EGFR, cystatin C, and the check on the check
Estimated glomerular filtration rate is a calculation with muscle mass in the denominator of its assumptions. In this population that matters.
What the trials monitored, and what that implies about routine practice
Timing is the whole of the post-cessation panel: draw it too early and it measures the treatment period.