Dr. Christian Gersch
During my family vacation at a restaurant for dinner, I sat at a large table, my children happily spooning away, and I chatted with other travelers about healthy eating.
When someone asks me if I have any general nutritional advice, I like to tell them about the rather unconventional positions in my book.
I am a private practitioner with a focus on longevity medicine, and anyone who comes to our practice receives my "patient handbook", which contains the recommendations I give people to start with.
For example, I advise them not to consume more than 1 g of omega-6 fatty acids and 0.5 g of omega-3 fatty acids per day.
Digression: Tobias' experiences on the subject of fatty acids
I told the person sitting next to me that this was not just about theory and studies, but that I could also show patients through blood tests what positive effect a reduction in the consumption of polyunsaturated omega fatty acids would have on their bodies.
Interested, he asked whether this could also be seen in the "complete blood count"? His family doctor does this from time to time and it is always great.
That evening, I suddenly realized that people are often "sold" a "complete blood count" as a comprehensive laboratory test.
I explained to the person I was talking to that very special blood tests were needed to make statements about fats becoming rancid in the body, which unfortunately were not included in a "complete blood count". You would have to do a special test for oxidized cholesterol, for example.
He was genuinely surprised.
I would therefore like to briefly introduce you to what a complete blood count actually is...
...and why I hardly ever decide on it:
A "blood count" actually only looks at three different types of cells:
- the red blood cells (erythrocytes) - these make up approx. 43% of the blood
- the white blood cells (leukocytes) and
- platelets (thrombocytes), which together make up around 2 % of the blood.
If it is a "small" blood count, only the number of these cells is determined as well as the concentration, size and composition of the erythrocytes.
A small blood count costs around four euros and tells you whether (and possibly which) anaemia is present, whether there could be inflammation and whether the blood coagulation system has a sufficient supply of one of its central building blocks. I like to do this often (as do all other doctors and hospitals) because it gives me a lot of basic information about a patient's state of health without costing him or his insurance company a lot of money.
A "big" blood count is basically the same as a "small" blood count, except that the types of leukocytes found in the blood sample are also determined. The white blood cells are differentiated into five subtypes (basophil, eosinophil and neutrophil granulocytes as well as lymphocytes and monocytes) and their quantity and the degree of maturity of the neutrophil granulocytes (fully developed or precursors from the bone marrow?) are measured.
It should only be determined if you are on the trail of an inflammation (allergy? viral infection? bacterial infection?), a malfunction of the immune system or blood cancer.
However, this question rarely arises.
In fact, all other blood tests are aimed at determining values in the "blood serum", the part of the blood that is around 55% cell-free.)
The problem is that a complete blood count only costs about one euro more than a small blood count, and therefore doesn't reveal much more - but the term sounds so much better.
In comparison, the test for oxidized cholesterol that I mentioned costs around five times as much, and a determination of the types of omega fatty acids in the blood costs almost ten times as much.
The laboratory budget of a statutory health insurance doctor will often not allow for such costs, and many laboratories do not even offer such tests. Otherwise, expensive test materials would have to be kept on hand and possibly disposed of unused after expiry. Only a few specialist laboratories offer these tests. However, depending on the question, these tests are really meaningful.
If a "complete blood count" shows that everything is fine, you can of course breathe a sigh of relief if you were worried that you might have leukemia - blood cancer. But in other cases - especially in the case of non-specific health problems or a drop in performance - a complete blood count was neither indicated nor does it say anything useful.
Other common tests - such as the check-up provided by statutory health insurance companies - only determine a few values in the blood serum, such as total cholesterol and the amount of two lipoproteins ("non-HDL and LDL cholesterol"), triglycerides and blood sugar levels. For "cholesterol" alone, numerous other tests are also possible, some of which are much more informative, but these would have to be requested separately. The check-up is by no means bad - but it is still only a rough screening in which many things are never tested.
I would like to make it clear that doctors do not receive any commissions, kick-back payments or similar for "third-party labs" sent in. That would now even be a criminal offense. Even though I often have laboratory tests done worth several hundred euros, which the laboratory company charges my patients directly for, the only thing I get back is the written findings (and - admittedly - really courteous customer service). A doctor can only bill the patient directly for the "basic laboratory", which includes the blood count and any tests carried out on site. So it is not true that increased blood tests are money-making at the expense of patients or insurance companies.
The real difference, by the way, is not the cost
- it is the time.
Of course, it takes much less time to tell a patient that "everything is fine" in their complete blood count than to explain to them in detail that the measured blood lipid composition is anything but good and that a change in diet can only be urgently recommended, even if the typical cholesterol values still look "normal" and the problems can only be seen in special tests.
However, the effort involved in arranging such laboratory tests and then explaining them accordingly can be worth a lot. Sometimes it can make the difference between an early heart attack and a happy, healthy and long life.
"PRACTICALLY ALL MY PATIENTS BECAME DEMONSTRABLY HEALTHY THANKS TO A LOW-LECTIN, LECTIN-FREE DIET.
THEIR INFLAMMATION LEVELS FELL BELOW THE DETECTION LIMIT.
DR.MED. CHRISTIAN GERSCH
LONGEVITY PHYSICIAN
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