MASH biomarker panel — need advice

Dr.LeslieOBGYN said:

Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c…

That reframing is the part I needed. Printing the relevant bit and taking it with me.

Adding the clinical framing, because it changes how the question reads.

PSA: get baseline labs BEFORE starting baseline bloodwork therapy. You need a "before" picture to measure progress. My recommended pre-treatment panel:

1. CMP + A1C + fasting insulin
2. Complete lipid panel with particle count if possible
3. hsCRP, ferritin, B12, vitamin D
4. Thyroid panel (TSH + free T4)
5. CBC with differential
6. Liver panel (ALT, AST, GGT)
7. DEXA scan or body composition

Total cost at Quest without insurance: ~$200. Worth every penny for the data.

Dr.KarenChen said:

The liver data is among the strongest non-weight findings in the class.

Shot day Thursday report relevant to baseline bloodwork:

Week 44. Currently on 2.4mg. Down 70 lbs from starting weight of 282 lbs.

This week's observations: Energy levels excellent, zero nausea.

Labs due next week — looking forward to seeing the metabolic panel. I'll post results in the Lab Results section when they come in.

carl_compliance said:

A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin…

Blood work came back perfect. baseline bloodwork + this community = winning. 🏆

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Tagging this one for the weekly digest.