Newsletter

Nobody thinks iron has anything to do with insulin resistance

Nobody thinks iron has anything to do with insulin resistance. Nobody pairs iron with insulin resistance. There is no reason to, if you are reading labs one at a time. Here is what her iron and ferritin did across four years while she was busy fixing her insulin. Iron went from 105 down to 85. Twenty points, downward, ...

She didn’t improve. She relocated.

Hey Reader, Dr Karl here. She didn't improve. She relocated. ​ This is the sentence I most want you to take from all of this. Her HOMA-IR went from 2.6 to 0.8. The easy way to describe that is "she improved." It is also the wrong way, and the difference matters more than almost anything else I could tell you. She ...

I sort my entire dataset by one number

Hey Reader, Dr Karl here. Here is the thing almost nobody does, and it is the reason this work looks different from everything else you have seen. I take every client I have ever worked with, every lab, twelve years of it. Each person becomes a row. Each lab becomes a variable. Then I split the whole thing in half ...

Flat and boring

Hey Reader, Dr Karl here. Flat and boring. If you have ever worn a continuous glucose monitor, you already know what I am about to show you, and you probably did not know it was the point. Four years ago her CGM trace was jagged. Peaks, drops, more peaks. Today it is a low flat line that barely moves all day. Flat ...

Her fasting insulin was 9.6. Her doctor said she was fine

Hey Reader, Dr Karl here. Nine point six. ​That is where her fasting insulin sat four years ago. On a Labcorp range runs 2.6–24.9 µIU/mL so 9.6 prints without a flag. ...