it's going to cost me $200 to get a celiac test.

i may be able to sequence my genome for $300.

the latter is a better investment, for sure.

fasting for non-medical reasons is retarded.

my gastrin came in at 39, which is lowish but not clinical. i want that more around 50-75 when fasting; it came in at 76 after a meal.

so, i'm not producing as much gastrin as i'd like and that might be some key information, although where i go with it is less clear. 

the osteocalcin came in at 18, which is on the higher end of turnover markers. but, i was fasting, so my body may have been using my bones for minerals. this seems to be a delicate metric - 18 is considered to be normal, 19 is considered to be osteopenia and 22 is considered to be osteoporosis.

i would have liked this number to be a little lower, and the most likely cause is indeed estrogen deficiency combined with not eating. ii wish i had done it without a fast... 

so, should i do it again? not yet - there's other markers to look at that don't cost $70.

so, i tried to wake up this morning and get some things done today and my body just knocked me right out, instead. i put up no resistance, on this day.

having the bone thing clarified lifted somewhat of a weight from me and relieved a lot of stress. i think i needed a hard reset.

but, let's try to have a long day today and get those things done tomorrow, instead.

and, should i get a dna test?

the chart on the right is the data from nhanes that the lab probably should have used. what are the categories? "white male" is not the best for me, probably - something like west asian or mediterranean would be more accurate. but, that -1.9 shifts to a -.5.

the data on the left is about chinese men, and it's almost a flat 0.

final conclusions on this: finish the blood tests and follow through with the endo. get as much data from the lab as is possible. but, i've never broken a bone and should avoid dramatic reactions.

i just need to make sure i'm walking enough. 

that is all.

this is the third machine in that study and would give me a z-score of around -1.1.

https://www.researchgate.net/figure/Women-femoral-neck-BMD-standard-values-DCS-900_tbl11_236104423

so, using this study as reference, i can construct z-scores of:

-0.87

-1.1

+ 0.78

for normal female reference values, which i'm going to use as a baseline because i'm estrogen dominant and it's the most applicable chemistry.

that suggests that i'm in a normal reference frame for women my age, relative to a reasonable concept of error.

but, i still want the calibration.

ok.

so, that study was about comparing three different machines.

this is from the same study, using a different machine - and is closer to the values i got from the local diagnostic. 

the takeaway is that these machines are doing something rather crude and that, while they may present small standard deviations, they're also operating in a substantive amount of error. you should approach this as a starting point and use some caution.

so, i should follow through with the blood tests, but be a little more relaxed about it - it's probably fine, and there's probably not much i can do, anyways, besides make sure i'm walking in addition to bicycling.

https://www.researchgate.net/figure/Women-femoral-neck-BMD-standard-values-DPX_tbl8_236104423

this is japanese data, and would suggest my bmd of 0.784 is pretty good for a 40 year-old woman.

i want to standardize the data, though; yes, i could calculate this myself, but i want them to do it so it's calibrated.

https://www.researchgate.net/figure/Women-femoral-neck-BMD-standard-values-QDR_tbl5_236104423

i still want the following data from the centre, if i can get it:

- under 50 z-scores for white female reference.

am i white? not really - not genetically. this is a great example of the fallacy of doing medical diagnostics on a person based on their skin colour. i haven't had genetic tests, and i don't know if my bone density is likely to be dominated by my white irish genes, my caucasian jewish genes, my central asian finnish genes, my native american genes or my hypothesized malagasy genes. there's absolutely no reason to think that i got the irish genes for bone density just because i have...i actually have a mediterranean type complexion, at least in the summer. i'm not ghastly white....

looking at me and deciding i'm phenotypically white, therefore i have caucasian bones genes is completely fucking absolutely scientifically wrong. but, it's what they did.

regardless, i'm going to ask for a white female reference 'cause whitie's got weakling bones. it's the lowest end of variability.

- t-scores for white male and female references

i can guesstimate it's around -.5 as the difference between a z-score and t-score in context is that the z-score removes the variability in the data for the oldest and weakest. but let's see it.

- z-scores for white male and female references in he next highest age category, presumably ages 50-60. 

biking is great for your heart, which has been my focus because there's heart issues on my dad's side - dead grandfather, dead uncle and probably-would-have-got-him-if-cancer-didn't dead dad. i've known for years that this was my biggest challenge, and my heart is in excellent shape because i addressed it.

i never gave a passing thought to my bone density; now that i have, i need to make sure i'm walking, too, and not just biking everywhere.

so, i'm too relieved to get pissed off.

but, it's a valuable lesson, regardless.

but, as far as i can tell, the best thing i can do for that specific little hip bone is walk more.

my doctor told me over the phone that my lumbar spine t-score was -1.9, using female reference values. he therefore diagnosed me with osteopenia over the phone and scared the fuck out of me.

when i picked up the data from his office yesterday to try to get a better handle on it, i learned that my lumbar spine z-score was -1.2, using male reference values. as a 40 year-old, that is more or less exactly where it ought to be in an "under 50" pool of references - i've had about ten years worth of loss, so i should be on the lower end when compared against young people. 

my total femoral z-score was even better, at -0.8. that is probably above average for my age.

that -1.9 was a z-score for my femoral neck, and it's a little concerning, but still in the normal male reference frame. could that be caused by heavy biking or overuse? like, have i worn it down, actually?

but, i therefore don't have osteopenia at all. what i have is a doctor that doesn't know how to read bmd test results. and, this is both relieving and annoying and clears out a lot of the bloodwork i was concerned about.

i'm going to follow through with the endocrinologist, regardless.