Question 55 of 433
What are the tests most doctors do not order that you wish they would?
The short answer
Lp(a) once in adulthood, and ApoB when it helps resolve risk, deserve wider discussion. A calcium score is useful when it could change a treatment decision.
Those recommendations do not turn every advanced marker into a screening requirement. The 2026 lipid guideline supports selective ApoB use and selective coronary calcium scoring. hs-CRP can help in some risk discussions. Routine fasting-insulin screening has not been shown to improve outcomes.
Ask a clinician to explain a declined test before assuming the refusal is poor care. Your age, symptoms, previous results, treatment plan, and insurance coverage all matter. A thoughtful explanation is more valuable than a longer requisition.
“This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship.” From the book’s medical disclaimer. Full disclaimer
GUIDELINE-BASED / CLINICAL JUDGMENT — Lp(a) once, selective ApoB and CAC; not routine fasting-insulin screening.Evidence grade (draft mapping)GGuideline-based / consensusPart 4, Q55 · Sources: R1, R4
Sources cited
- R1 Sacks DB et al. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus. Diabetes Care. 2023;46:e151–e199. doi:10.2337/dci23-0036. PubMed 37471273DOI 10.2337/dci23-0036✓ Verified
- R4 Blumenthal RS et al. 2026 ACC/AHA multisociety Guideline on the Management of Dyslipidemia. Journal of the American College of Cardiology. 2026. doi:10.1016/j.jacc.2025.11.016. Link pending verification
From Longevity Unmasked by Afshine Ash Emrani, MD, FACC. Medical disclaimer. This book is for education. It is not medical advice, and reading it does not make you my patient or create a doctor-patient relationship. Nothing here is meant to diagnose, treat, cure, or prevent any disease. Medicine is personal: a test, drug, supplement, or exercise plan that helps one person can harm another. Do not start, stop, or change any medication or treatment because of something you read in these pages. Talk with a licensed clinician who knows your history first. If you think you are having a medical emergency, call 911. The author disclaims responsibility for any loss or harm arising from use of the information in this book.