NMS does not list consumers as their customers, and none of their customers make medical decisions based on their lab work.
NMS claims CLIA certification. This is the older law where labs self-certify compliance. Congress left CLIA in place alongside FDA IVD regulations to protect small pharmacists, but obviously Quest Diagnostics and LabCorp run fleets through that loophole, and most labwork is CLIA-certified, not FDA-approved.
Paying to test for highly-prevalent, possibly-toxic, pervasively-feared, under-studied chemicals is an ideal recipe for fleecing people with no real benefit.
Perhaps worse, if people get burned because it is corrupt, it puts people off trusting good providers. This is not just "Hey I made an app/web-site to track your period! How cool is that?" Some chemicals may be toxic, but so is fear.
So yes, it's super important to enable people to concretely understand their risks, protect themselves, and advocate for health policies. All the more reason to do it right.
So I hope you know what you're doing. Somehow the website needs to convey the organization behind it, and why that organization can be trusted to do this right, and not to mislead people.
mdek 670 days ago [-]
> NMS claims CLIA certification. This is the older law where labs self-certify compliance. Congress left CLIA in place alongside FDA IVD regulations to protect small pharmacists, but obviously Quest Diagnostics and LabCorp run fleets through that loophole, and most labwork is CLIA-certified, not FDA-approved.
This is highly misleading. CLIA and the associated federal regulations are the standard to which diagnostic clinical laboratories are held, not an "older" or "loophole" regulation. All laboratories in the US that provide patient results for clinical use are regulated by CLIA. There are FDA-approved test systems and "Lab-developed tests" (LDTs) that are BOTH subject to CLIA obligations, which are unbelievably complex (and in my opinion are a source of regulatory capture in laboratory medicine, but that's not directly relevant). Most high complexity lab tests are LDTs.
FDA-approved tests go through a formal FDA process such that the performing lab only has to "verify" the performance characteristics prior to patient testing. An LDT requires a much more stringent lab-level validation plan prior to patient testing. Both requiring strict ongoing quality control and quality assurance. And while the validation plan for an LDT can be self-designed, there are still strict requirements for what it most contain.
Compliance is NOT "self-certified," instead there are routine, extremely intensive compliance inspections (scheduled and unscheduled), either by a regional CLIA office, or by an organization accredited by CMS to provide such verification of compliance (such as CAP or COLA). These are not cursory inspections but a deep dive into all lab operations and personnel, equipment, maintenance and quality records, and other documentation.
I'm not a huge fan of Quest or Labcorp's presence in the field, and I don't know the specifics of NMS and this PFAS testing (CLIA compliance isn't required for research or non-clinical). If NMS has CLIA certification and they state the methodology and limitations of their LDT it's generally perfectly valid to provide the test, and the burden is generally on the downstream physician or provider to ensure the results are properly interpreted and applied.
670 days ago [-]
mdrew 671 days ago [-]
Ok, a few thoughts.
Direct to consumer lab testing is offered in ~47 states in the country. It has been available for years with thousands of tests available. To date, there has been no apocalypse from empowering consumers to know about their own personal health.
NMS is one of the preeminent toxicology labs in the country. This test is Liquid chromatography–mass spectrometry which is known, quantifiable, extremely accurate and repeatable test methodology.
National Academies of Science, Engineering and Medicine explicitly references this lab in their report. Further, they go on to elucidate the risks and benefits of offering PFAS testing to people.
"Harms of PFAS testing include fear induced by blood draw, a small risk of injury or infection at the draw site, difficulties in interpreting results, and psychological stress that may occur when people who are tested learn that they or their family members have high levels of PFAS exposure. On the other hand, biomonitoring for PFAS blood levels may also alleviate fears associated with not knowing one’s PFAS levels. Another potential benefit is increasing awareness of exposure so that exposures can be reduced. If sources of exposure are identified, actions taken to reduce these exposures, such as using a water filter, may also benefit family members in addition to the person who was tested. Community-level benefits may be associated with PFAS testing as well, such as empowering communities to respond to contamination and providing a baseline with which to evaluate the impact of community-level interventions to reduce exposure. Additionally, biomonitoring for PFAS in the context of epidemiologic studies could provide more information about PFAS-associated health effects."
Also a couple of quotes from the same paper.
"Kristen Mello of Westfield Residents Advocating for Themselves (WRAFT) said to the committee:
You don’t have a problem getting an insurance assessor when your car is hit, you don’t have a problem getting an insurance assessor when you have a tornado, but this slow motion unfolding environmental and public health disaster … is intentionally keeping the information from us so that we cannot take action.
Furthermore, Emily Donovan of Clean Cape Fear, said:
Sadly it feels like guinea pigs are treated better, because at least their exposures are thoroughly studied for the betterment of humanity.
And Cathy Wusterbarth of Need Our Water said:
We’ve tested the fish; we’ve tested the deer; we’ve tested the groundwater, the waterways, and the foam. When are we going to test the people?… The only risk [of testing] is to the polluters who do not want us to link them to our exposure."
Went to doctors dozens of times with severe but vague symptoms. Was admonished repeatedly for doing my own research. All the doctors get saying it was anxiety, and that I was simply a hypochondriac. After years of this found out I had 3 fairly uncommon conditions that mixed to produce crazy issues. Proper treatment resolved my issues.
I’ve met many others who have had similar problems.
Consumers should always be allowed to do their own research.
xracy 670 days ago [-]
I don't think the previous commenter was saying "don't test people" but there are a few comments on here about how sketchy this website/company looks.
So instead, the question is, if I pay $400 what meaning/value am I getting from this. And what can I get above and beyond the given 98% certainty I have that I've already ingested one of these chemicals?
mdrew 670 days ago [-]
I get it.
I think it's right there in the post itself. If you have certain occupations, live in certain zip codes, or have medical problems, a test like this can prove invaluable.
If you're just curious, your mileage may very.
I do push back on the idea that not knowing is somehow better. Or people cannot handle learning new information about themselves. It's an old idea from medicine I hope we can move past as it just entrenches the power dynamic between caregivers and patients.
vkou 670 days ago [-]
> I think it's right there in the post itself. If you have certain occupations, live in certain zip codes, or have medical problems, a test like this can prove invaluable.
Invaluable, as in, worthless?
Invaluable for what? What are you going to do if you test positive?
mdrew 670 days ago [-]
I encourage you to read the rest of the discussion.
xracy 670 days ago [-]
Uhh, you haven't answered this person's question in the rest of the discussion. What is the value of this test over assuming that I have this? What treatment exists that I can get if I know my blood contains PFAs?
mdrew 670 days ago [-]
Depending on your Total PFAS blood level, you are at increased risk for certain medical conditions which require ongoing monitoring by a physician. Knowing this may prevent the development of future diseases or allow you to catch it early in its progression. NIH graphic: https://res.cloudinary.com/mpsh87/image/upload/v1687923551/N...
If your level is significantly elevated (>20 ng/mL), you can audit your environment by testing your tap water and installing a reverse osmosis whole house filter (expensive). If your level is low, you don't need to do any of this. By eliminating point source exposure, your PFAS levels would naturally decline in time.
Lastly, I bring up therapeutic phlebotomy as interesting emerging research because it points in a concrete direction to something that is very actionable (pending more study).
Edit: grammer
xracy 670 days ago [-]
Somewhere else in this comment section there's a discussion about screenings causing more trouble than benefit because people don't know how or what to do about them.
Emerging research is not something actually concretely actionable for most people. Worse, because most people are "arm-chair experts" without clear guidance, your average person is more likely to harm themselves with doing their own research into things like this than otherwise.
For the additional thing about "reverse osmosis whole house filter" most people likely can't do afford to do this. Even if they can, there would need to be much better guidance here to have any certainty that someone wasn't selling you snake oil. The only things I can find on these systems in searches is that the companies that sell them recommend them, and won't even say they can filter out PFAs on their own, that's a major red flag to me that this is poorly regulated and likely dangerously marketed for things they can't do anything about.
A thought experiment, if I offer you two glasses of water, and tell you one has PFAs and the other doesn't how could you actually test that assumption? How could you have certainty in that test? I'm not saying it can't be done, but knowing what companies you can trust in a brand new space is not something obvious, and especially in a low-regulation space can be a major opportunity for companies to use meaningless words to try and convince you they're doing more than they are.
I had an insect exterminator come to my door and tell me the "eco" in their company name meant that they were eco-friendly with 0 data to back that up. They also said that all of their chemicals for killing animals were "plant-based" and didn't expand on that any further. Companies can make a lot of money making up BS terms to try and sell you the same thing you've been buying for years. That's a lot easier than finding a new thing to sell you.
leksak 670 days ago [-]
You sound defensive
mdrew 670 days ago [-]
Just pushing back mildly on the whole "fleecing people" language and implication that NMS labs is somehow "corrupt" with no evidence.
azinman2 670 days ago [-]
But I cannot order this test myself from NMS, right?
mdrew 670 days ago [-]
NMS does not offer tests direct to consumers.
azinman2 670 days ago [-]
Are there labs where I can go in and order arbitrary tests?
codingdave 670 days ago [-]
Yep, search for "direct lab testing" and you'll find some vendors, and possibly some local clinics.
But the thing with ordering your own tests is that it is not the only way to get these results. You can simply ask a doctor. They'll order it and help you understand the results and insurance can cover it. Depending on your insurance, that might be cheaper or it might not. There are pros and cons to both approaches mostly centered around how self-driven you want your care to be and whether or not you have a cooperative doctor.
But I would add a general word of warning - raw lab results do need some broader understanding of what the expected results are. They'll typically tell you what numbers are too low/high, but will not tell you what it means if you are outside those limits. For some things, being a slight bit out of the norms is a big deal. For others, unless you are at a few multiples beyond the limits, there is northing to fret over. Knowing which is which is critical to know how to react to test results.
I'm not saying you've gotta work with doctors - I'm saying that they do have a point that self-educated and self-diagnosed patients who learn the info off the internet are not always well-informed. If you are going to go the self-directed route for your health care, take the time to learn deeply and do it well.
mdrew 670 days ago [-]
Well said. If you're not well informed, this isn't for you.
ShakataGaNai 671 days ago [-]
This is interesting, and I suppose has a use of "data over time" but I fail to see how this testing is of any actionable value for the average person. So you're exposed, and PFAS is in EVERYTHING.... so ... what should I do? Nothing realistically. Unless I find an obvious source like my water, there isn't much I can do besides replacing my cooking pans. I can replace my pans without this test.
It's a little like those ads to sell you a full body MRI. Most doctors recommend against them because you're likely to do more harm to yourself than they actually fix something.
If you're concerned about PFAS, live a healthy life and skip spending money on the testing. Live somewhere with PFAS in the water? Get a reverse osmosis filter. Replace your cookware with something that doesn't contain PFAS. Don't use storage containers for food with PFAS. Check your water bottles.
Then live your life, because until we change as a society, there is only so much you can do.
mdrew 671 days ago [-]
I would also say this attitude was pervasive when we used leaded gasoline, which widely contaminated the biosphere, roads and people.
It's everywhere. We all have it. Why bother.
I think we now know there's no safe level of lead in the blood. If you have suspected exposure in 2023, doctors quantify your lead level through a blood test and if it's elevated, recommend a medical procedure called chelation to remove it.
With PFAS, the medicine is just starting to catch up to the horrors of the news cycle.
But I think in the future, PFAS contamination is going to be treated in a similar way to lead exposure. That is, medically.
But right now, it's easy to throw up ones hands and say, it's all fucked. Why bother doing anything.
ShakataGaNai 671 days ago [-]
So the "what should I do?" was the big question.
Even in your OP, you said you didn't know what to do about it. Neither does the website say much other than basically "lawyer". If there is something I can do to help me, then there is a purpose to the test. This chelation you mentioned.
But again, this should be a "See a doctor first" situation. What are the risks of chelation? Is it safer for me to have PFAS than go through chelation?
I don't have all the answers. Just trying to provide one small solution in the chain.
ars 671 days ago [-]
So far as I know chelation is not effective for PFAS, chelation is for metals.
PFAS will eventually (slowly) leave your body - focus on not getting anymore, not on removing it. I posted a comment with suggestions elsewhere in this thread.
mdrew 671 days ago [-]
Correct. I was using lead chelation as an analogy for the medical management of PFAS contamination.
azinman2 670 days ago [-]
Evidence so far is that plasma and blood donations can remove it slowly.
giantg2 671 days ago [-]
"to get rid of PFAS, but nothing about from the human body."
We have some really old tech that can reduce your levels -blood letting. (... or donation).
eutectic 671 days ago [-]
Well, in the case of lead, I don't think it was irrational for individuals to feel disempowered. The solution was regulatory and societal change, but how many people want to devote their lives to being PFAS crusaders?
mdrew 670 days ago [-]
Society is starting to change. EPAs super aggressive new water quality standards. Bans on PFAS in packaging.
PFAS crusader haha.
Edit: forgot the word water
rcme 670 days ago [-]
Lead in the blood is really just a side effect of chronic exposure. What’s currently considered elevated is something like 3.5 micrograms / dL. It’s equivalent to just a few specks of lead dust in your blood. The bigger issue is that lead in your blood means you have lead in your bones where it will poison you throughout your life.
dingnuts 671 days ago [-]
Correct me if I am wrong, but I thought the global lead poisoning hypothesis that was popularized by Neil DeGrasse Tyson's remake of Cosmos was determined to be based on extremely scant evidence and may have been outright false
A recent study in New Zealand found that blood lead levels of 3.5 micrograms / dL, which is the lowest easily detectable level, were associated with a drop of 1 IQ. People during the times of lead paint and leaded gasoline often had levels of 80 micrograms / dL. It seriously messed them up.
mdrew 670 days ago [-]
Our first version of the site was PFAS.wtf but that didn't test well
mhardcastle 671 days ago [-]
Donating blood or plasma has evidence of reducing pfas. If I knew I had high measured levels, I'd certainly think about doing it more.
The negative health effects of PFAS are completely irrelevant if the alternative to this "bad blood" is death.
giantg2 671 days ago [-]
Generally agree, but that could be true of many other things like lead too. So we have to be careful not to take it to the extreme.
jsharf 671 days ago [-]
Well, assuming they likely have some PFAS already in their system, you might just be giving them blood with the same concentration of PFAS that they already have.
mianosm 671 days ago [-]
Not always, as quite often the donation is on hand, but not necessarily used.
Also: better to save a life and either average down whatever PFA count they have, or bolster their blood volume so they can start producing their own lower PFA infested hemoglobin.
Lesser of evils, and kind of a win win: if everyone was blood letting for the safety and humanity of others.
If you're donating because you know your levels are elevated then I'd agree with this thought.
(While also agreeing with those in the thread saying that high-PFAS donations are likely often better than no donations)
mdrew 671 days ago [-]
I think for certain high risk populations, specifically pregnant women or women planning on becoming pregnant, it makes sense.
Based on the new clinical recommendations, my 10.86 ng/mL level puts me at elevated risk for preeclampsia (if I were a women/pregnant). Knowing that could mean my BP during pregnancy is more closely monitored, with a BP cuff for example.
prepend 671 days ago [-]
> I think for certain high risk populations, specifically pregnant women or women planning on becoming pregnant, it makes sense.
Does it though? What will a pregnant woman do based on her results? Will having PFAS affect someone’s decision about becoming pregnant?
Pregnant women are going to monitor BP anyway. And the intervention is $100 for a BP cuff so that’s cheaper than the test. So we’re better off just recommending monitoring BP more closely than this test.
mdrew 671 days ago [-]
Since this is an out of pocket test not covered by medicaid/medicare, I don't know if the value based care argument is that relevant. I know what you're saying though.
The value we provide: If people want to know, they can now know.
I also think not making the test accessible also has downsides.
prepend 670 days ago [-]
It’s good the test is available.
What I mean is what would justify someone spending $400. The example of pregnancy is not a good one, as someone is better off just monitoring blood pressure (which is already common advice for all expectant mothers) for $100 instead of paying for this test.
I think value based healthcare is more important when people pay themselves.
Since there’s no intervention based on the results, it’s not a good idea for people until the results are actionable.
0cf8612b2e1e 671 days ago [-]
Time to start blood letting. A human has ~5 liters of blood and blood donations are 0.5 liters, every two months. So with a year of effort, could cut your levels in half (0.9^6 = 53%).
mdrew 671 days ago [-]
I believe they let you donate every 6 weeks
stepbeek 671 days ago [-]
Depends on country. UK is every three months.
ShakataGaNai 671 days ago [-]
That's fair. So like any other testing, this is only useful for a small population, and you should consult your doctor first.
mdrew 671 days ago [-]
You'd want a good reason to test
ars 671 days ago [-]
There's tons of things you can do.
What you should not bother doing is replacing your cooking pans because PFAS does not come from that. (Nor does it come from food storage containers or water bottles.)
The first thing to do is avoid paper dishes, no paper straws or any other kind of compostable dishware. The are frequently sprayed with PFAS to make them waterproof, and unless you are buying them yourself and checking you have no way to know what kind they are.
Avoid snowboarding - snowboards (and skis also I think) are sprayed with PFAS to make them slippery. The snow in the area will be covered in it, so just don't do that kind of sport.
Check your outdoor clothing, and kind of breathable clothing that is also waterproof is most likely coated with PFAS to make that happen. This is not just rain jackets, but also active-wear advertised as "quick drying".
Add a carbon filter (any kind) to your drinking water, you don't need reverse osmossis, carbon works fine. And helps for tons of other things you don't know are in there - plus it tastes better.
As a general rule any time you see an object that should get soaked with water stay dry be careful!
mdrew 671 days ago [-]
Those waterproof jackets from REI that magically shed water droplets... for 9 months until the coating wears off and your jacket is just soggy
upsidesinclude 671 days ago [-]
>so ... what should I do?
>replace my pans
>Get a reverse osmosis filter. Replace your cookware with something that doesn't contain PFAS. Don't use storage containers for food with PFAS. Check your water bottles.
Oh, so all of that would be a good start for anyone and everyone.
The test can help to determine if something, like blood donation, might be a reasonable course of action for a specific person.
This is a great test and a worthwhile addition to our understanding of how prevalent these substances are within the the body.
Any reduction of PFAS in the blood would be beneficial as they are endocrine disruptors.
prepend 671 days ago [-]
According to their site you should consult an attorney.
This falls into the “neat, but what can I do” category and at $400, someone really needs to be into self data.
ShakataGaNai 671 days ago [-]
Well $400 for them to order the test for you, then however much for quest to actually do the test.
671 days ago [-]
eutectic 671 days ago [-]
PFAS are used in the manufacture of teflon pans, but teflon pans themselves are not a major source (as I understand it).
autoexec 670 days ago [-]
Quest Diagnostics is pretty sketchy. They've been busted for fraud, illegal kickbacks, inaccurate tests, privacy violations, etc. They sell every scrap of data they can get away with to third parties including marketers and it's a lot of data (https://www.questdiagnostics.com/our-company/privacy/privacy...) which includes: Professional/employment-related information, products or services purchased/obtained/considered, consumer’s preferences, characteristics, psychological trends, predispositions, behavior, attitudes, intelligence, abilities, and aptitudes. driver’s license/national or state ID number, citizenship status, immigration status, race, national origin, religious or philosophical beliefs, sexual orientation, sex life, precise geolocation, information concerning your health, and genetic information.
akiselev 670 days ago [-]
They've also contacted my emergency contacts in an attempt to collect payment for blood tests when they made a mistake writing down my insurance information... that was already sent to them by the doctor ordering the test. The link to the receipt in the text message listed enough details about the blood tests to deduce some very private information.
I have never in my life seen a more flagrant and willful violation of HIPAA. It's the only time I have ever contacted my state AG or the HHS.
autoexec 670 days ago [-]
They clearly have a very different view of what constitutes an emergency than most of us. Did your AG get back you?
wswope 670 days ago [-]
Fully agreed that it's scuzzy, but wouldn't that legally fall under TPO?
mdrew 670 days ago [-]
The only information we use to generate your lab req in Quest is:
name
dob
biological sex
phone number
autoexec 670 days ago [-]
I imagine the bulk of your data is collected when you show up for the blood draw. You have a really nice site, but should defiantly try to find and work with a more ethical and trustworthy lab. On the plus side, when they sold your data they probably had a lot of nice things to say about your intelligence, abilities, and aptitudes!
exmadscientist 670 days ago [-]
Quest is one of the two major testing companies in the US. (And LabCorp is not much better.)
I understand the sentiment here, but it's like saying "you should definitely try and find and work with a more ethical political party than the [reader's choice: Democrats|Republicans]". Good luck! It's not likely to happen, even if we all wish otherwise.
autoexec 670 days ago [-]
It looks like those two companies have been buying up competitors left and right for a long time, so no wonder there aren't many other options left out there. Seems like this is an industry that doesn't get a lot of attention, but which is badly in need of oversight and regulation.
cmbuck 671 days ago [-]
I've previously been advised by my doctor that PFAS tests are of limited utility due to the lack of process controls which could introduce contamination. Given how novel this area of testing is and the prevalence of PFAS in all types of materials, you can't know whether any detection of PFAS in your blood sample is due to presence in your body or presence in the lab + testing equipment. How does your solution through Quest address this issue?
mdrew 671 days ago [-]
I would say it could be an issue, but is controlled for. The Quest Interface has a special cautionary statement for phlebotomists collecting samples for this test that says; "Note: Sample collection devices coated with PTFE/Teflon® and PVDF should be avoided because of potential specimen contamination."
Edit: grammer
cmbuck 670 days ago [-]
This guidance may help for sample collection, but wouldn't fully address the whole chain of custody. If the test equipment or handling tools/processes in the lab expose the samples to PFAS, then the test is botched. And this is challenging because PFAS are so prevalent and ubiquitous.
Don't get me wrong, I would love to have a test available for PFAS levels. However I've previously been denied a test from the medical provider due to the issues I've outlined above. So I think it would be helpful to know if/how they have addressed this problem.
mchannon 671 days ago [-]
This is kind of sobering.
Standard male levels of testosterone are between 3-7 ng/mL.
Standard female levels of testosterone are between 0.1-0.7 ng/mL.
And you're over 10 ng/mL of this crap?
Even if this stuff is a fraction as bioactive as testosterone, having more of it might explain a few societal health trends.
mdrew 671 days ago [-]
Wow I hadn't thought about that. Really puts it into perspective.
Eigenstate 670 days ago [-]
That's hardly an apples to apples comparison. A typical American has around 100 ng/mL selenium in their blood. By your logic, that's a toxic heavy metal that's ten times as bad as PFAS in terms of concentration. It's actually an essential cofactor in many biological processes. I'm not implying PFAS is harmless, but the dose makes the poison and it depends what biological processes are being interfered with.
supportengineer 671 days ago [-]
Are you saying that if you have low testosterone, you should get this test?
mchannon 671 days ago [-]
Not sure what I'm saying.
Correlation v. causation isn't all that well known here.
veave 671 days ago [-]
pfas are estrogenic. And yes, it explains a few things.
OscarTheGrinch 671 days ago [-]
What does it explain?
mtrpcic 671 days ago [-]
It explains nothing, anything in this thread will be pure conjecture unless there are peer reviewed studies that indicate otherwise.
brewdad 670 days ago [-]
This is the internet. If we can't offer up unsubstantiated conjecture, what are we even doing here?
/s
ethanbond 670 days ago [-]
We know that PFAS poisoning reduces sexual dimorphism (the difference between male and female physicality) and in animal studies it even affects dimorphic behavior. I.e. male and female animals in most species behave differently from each other, and when poisoned, they behave more similarly to each other.
The bush that people are beating around is the question as to whether this stuff is affecting sexual expression of humans en masse.
ok123456 671 days ago [-]
Guess I need to up the dose.
pwenzel 671 days ago [-]
I grew up in an area of the Twin Cities metro area of Minnesota that has very high PFAS contamination from decades of 3M's dumping of chemicals. Would love to get one of these tests once available in Minnesota!
I ended up receiving a few complete blood surveys in the process - comprehensive metabolic panel, hematocrit, cholesterol, testosterone, albumin, bilirubin, thyroid markers, and at least a dozen other medical terms that I don't fully understand, plus what's apparently a more comprehensive PFOA/PFOS study than this one, with dozens of varieties of PFOS/PFOA.
I had a total of 9.8 ug/L in my blood, after drinking water that was 78ppt PFOS for decades.
According to your link, there were tests done by the state in the past, were you unable to participate in those studies?
mdrew 670 days ago [-]
My level is 10.86 ng/mL
Your level was 9.8 ug/mL?
If so thats way way higher. I'm sorry.
Edit: grammer
LeifCarrotson 670 days ago [-]
No, ug/L, not ug/mL - sorry, my report gives units of 10^-6 grams per 10^0 liters, yours gives results in 10^-9 grams per 10^-3 liters; we have very similar levels.
bauruine 671 days ago [-]
>There's some research out of Australia indicating blood donation is effective at removing it from the body.
Great. Another reason to regularly donate blood. And you don't even have to pay 399$!
laweijfmvo 671 days ago [-]
Blood letting is back!
culi 671 days ago [-]
The closest modern medical operating room to you likely has live leeches on hand too. Looks like the tech never left
> "Despite all the technical advances in modern medicine, in certain post-surgical situations, we do still rely on one of nature’s most primitive organisms – the leech – to assist us in achieving a good outcome,” says Rod Rezaee, MD, UH otolaryngologist and head and neck surgeon.
Also great for reducing your blood iron levels if they're too high
supportengineer 671 days ago [-]
I can see the next YC pitch now for leeches by mail as a service.
Anon_Forever 671 days ago [-]
This made me audibly giggle. What's old is new again baby!
mdrew 671 days ago [-]
lol totally
Johnny555 671 days ago [-]
am currently deciding what to do next.
That's what I was wondering, what do you do with this information? How do you narrow down where your exposure came from?
mdrew 671 days ago [-]
Honestly it's super hard. And weird.
It reminds me of leaded gasoline in the 50s. It's everywhere. Everyone has it in their bodies. What now.
New regulations in California are banning this stuff in food packaging. And EPA just has new limits for tap water that are really aggressive.
So I think it's moving in a good direction.
Since my tap water isn't the issue, and I don't have any obvious other source of exposure, I'm currently focused on how to get out what's already in there.
Doesn't this end up in some other poor sap then? Wouldn't you want to have the blood collected and destroyed as medical hazmat, along with testing to confirm burden reduction?
Johnny555 671 days ago [-]
I think the guy that needs a blood or plasma transfusion is going to be much better off with it (even with the PFAS), than without.
CaptainNegative 671 days ago [-]
You're never concentrating the PFAS, so at worst you're bringing poor sap's new PFAS concentration closer to your own pre-transfusion levels.
So the question is whether they need the blood more than you did pre-transfusion. If they did, then you're still commiting a net positive. If not, then it serves them right for requesting a blood donation despite needing it less than did an individual who was ready to donate their own.
Unless the blood is going to research, in which case it is a net positive regardless.
jrockway 671 days ago [-]
It depends on the need for the blood, I guess. Getting a nanogram of PFAS is preferable to dying from blood loss. The nanogram of PFAS increases you chance of dying 5% sooner by 20%, whereas losing all your blood through a wound guarantees a 100% chance of dying in the next 20 minutes. (All made up numbers, but you can see the risk/reward balance.)
bauruine 671 days ago [-]
The people that received your blood have most likely "destroyed" alot of their own which most likely also contained PFAS thats why they need yours. No need to deliberately throw away perfectly good blood.
mdrew 671 days ago [-]
I wouldn't be surprised that in 5 years, there's a little drop down when you go to donate blood that asks if you're a firefighter, ski wax technician, factory worker or lived in certain contaminated zip codes. You select it, and they exclude you.
671 days ago [-]
logifail 671 days ago [-]
> forever chemicals
Sorry, but that phrase really annoys me.[0] What does it actually mean?
[0] full disclosure: PhD in organic chemistry
philipkglass 670 days ago [-]
It generally refers to polyfluoroalkyl substances, often abbreviated PFAS. The "bad" ones are hydrophobic compounds that can accumulate in fat tissue. There are some PFAS that do not appear harmful because they're nonreactive solids (e.g. pure PTFE) or because they're not hydrophobic enough to biomagnify (e.g. trifluoroacetic acid). Discussion of PFAS among non-chemists tends to elide the differences between all fluorinated organic molecules and the ones of environmental concern.
These compounds are not literally "forever" but they have long half-lives once released into the environment, due to the strength of C-F bonds and due to pollutants partitioning into low-degradation-activity environments. For example, a certain compound may be degraded by ultraviolet light from sun exposure, but tend to adsorb to soil where it's shielded from light.
PFAS share a lot of characteristics with the earlier-known "persistent organic pollutants" like polychlorinated biphenyls:
- Polyhalogenated organic compounds
- Low acute toxicity
- Endocrine disruptor activity
- Low rate of natural breakdown in the environment
In fact PFAS of concern share so many characteristics with the historically known PoPs that I am not sure why they got their own phrase "forever chemicals." They don't actually seem to have longer half-lives than those PoPs known by the 1970s.
For further reading, here is a page on PFAS from the Stockholm Convention on Persistent Organic Pollutants:
But we choose to use it because a lot of people don't know the chemistry but recognize this label.
azinman2 670 days ago [-]
As a layman, my understanding is that it doesn't break down over time. Is that not right?
DantesKite 671 days ago [-]
This is really cool.
Just being able to take blood tests in general to get a better sense of what might be going on can be so informative.
supportengineer 671 days ago [-]
Imagine the kind of data Quest Diagnostics is sitting on.
j2bax 670 days ago [-]
Hopefully AI can learn the language and make meaningful discoveries.
oezi 671 days ago [-]
Nice!
How can you interface with Quest diagnostics like this?
When you say that you are working to expand this to other locations what does this mean? Are you negotiating with other Quest labs?
The test is not approved by the FDA so why can they provide it?
Are you affiliated with the test provider or Quest in any way?
cypherpunks01 671 days ago [-]
I believe that any doctor is able to order any Quest tests, like this one.
Quest doesn't do the analysis on this particular test - Quest and LabCorp both send them out to NMS Labs in PA who performs the lab work.
mdrew 671 days ago [-]
Correct
mdrew 671 days ago [-]
Laboratory developed tests (LDTs) don't require FDA approval. However, this test is specifically referenced in the National Academies of Sciences, Engineering and Medicine PFAS exposure report (sort of the go to document for PFAS exposure and management). Link: https://www.ncbi.nlm.nih.gov/books/NBK584705/
We have a doctor we work with and a Quest account.
671 days ago [-]
JeremyBarbosa 671 days ago [-]
This is a great idea and I hope one day you can expand to the east coast so I can take the test myself. However, the price tag of $399 is pretty steep for something that just feeds my curiosity and can't be covered by insurance.
mdrew 671 days ago [-]
We're working on a way users can submit their lab req for reimbursement but it's complicated because America
prepend 671 days ago [-]
In what countries is it not complicated?
karmicthreat 671 days ago [-]
Why isn't this available in Michigan? We are PFAS central. Especially on the western side where I am.
mdrew 670 days ago [-]
As I understand it, aside from the local manufacturing, Michigan has one of the best testing programs in the country.
In other states, testing has been laggard. Which is maybe why some states have "low" levels.
mdrew 671 days ago [-]
We're working on it
mway 671 days ago [-]
Would you consider adding a "let me know when this is available in my area" notification signup (assuming you anticipate some delay between areas of availability)?
Any thoughts on where your personal exposure came from?
Also, I would love to see a histogram of results among the general population, if that can be found in the literature anywhere. I think it would be helpful context for result interpretation and a useful addition to your FAQ.
mdrew 671 days ago [-]
I'm not exactly sure.
My levels of PFOS was the highest, that's "Scotchgard". The house I live in has a very expensive reverse osmosis water filter on the tap so I don't think it's that.
Oh yea fish, did you also have above average mercury?
mdrew 671 days ago [-]
I'm not eating fish at the top of the food chain. Mostly sardines, lake trout, mackerel.
sschueller 671 days ago [-]
Clothing, food containers and cooking utensils would be my guess.
Remember the cool ads in the 90s for pants that would repell water and dirt?
wtsktte 671 days ago [-]
I tried to build an adjacent site a while back but couldn't figure out how to automatically generate the blood test. Quest doesn't appear to expose it via API. How are you generating the lab requisition form?
cypherpunks01 670 days ago [-]
Probably using.. a doctor. That is the only way to legally "generate" any arbitrary lab order. MDs can order lab tests in all US states, and I'm sure other licensed medical professionals have privileges to do so as well, depending on the state.
toomuchtodo 671 days ago [-]
This is awesome. Looking forward to your expansion beyond California and efforts to have insurance cover this diagnostic test.
Would also be cool to have an opt-in for folks to share their report, location, etc for research purposes.
mdrew 671 days ago [-]
In regards to the data collection, we thought about that but don't want to scare people off. Maybe zipcode is enough? We already added a small option dropdown for occupation.
bolangi 671 days ago [-]
I've used PTFE dental floss for decades, and recently diagnosed with a thyroid condition. I wonder if there could be a connection. This test will at least give me an idea of my blood levels of PFAS.
mdrew 671 days ago [-]
Honestly, the dental floss is the most fucked PFAS application out of all of them.
exhilaration 671 days ago [-]
What floss should one use to avoid these chemicals?
mdrew 671 days ago [-]
There's no PFAS labeling requirements and i bet a lot of the manufacturers lie anyways. I have no idea.
I went with Grin because they said it's PFAS free. Best I could do.
ars 671 days ago [-]
No, that is incorrect. PTFE is not a PFAS (it's chemically related, but is not the same).
You are perfectly fine with PTFE dental floss - it has no reactive PFAS components in it.
upsidesinclude 671 days ago [-]
That is not a good recommendation and is also incorrect
PTFE, the material, does not contain PFAS in bulk form.
That's the end.
Floss, as a product, could contain any number of compounds related to the manufacturing, packaging and coating.
mdrew 671 days ago [-]
Interesting.
upsidesinclude 671 days ago [-]
Take that with a grain of salt
mdrzn 670 days ago [-]
Maybe it's because I'm in EU and have never heard of "Quest Diagnostics" but my first thought was that I would be able to measure my blood with my Meta Quest 2
mhb 671 days ago [-]
Not sure if you intend this to be a going concern, but won't it be hard to compete against LabDirect et al.?
Ilnsk 671 days ago [-]
Pay $400 to a plaintiff so that he can then make $100 mil in a law suit that alleges representation of you.
giantg2 671 days ago [-]
"There's some research out of Australia indicating blood donation/phlebotomy is effective at removing it"
Kind of a "no shit" answer, and not a real solution - you're just transferring it to someone else. Probably some moral conundrum in there about how you are worried enough to get rid of your PFAS but are giving it to someone else.
mdrew 671 days ago [-]
I'm figuring this out in real time just like everyone else.
upsidesinclude 671 days ago [-]
I guess you'd also be giving someone extended life though right, so I guess that's for them to decide
giantg2 670 days ago [-]
I mean, you can make that claim about almost anything. It's really a fallacy where anything looks good if the alternative (usually a false dichotomy) is death.
brewdad 670 days ago [-]
If you are receiving a blood transfusion, death is almost certainly a likely outcome otherwise.
MicropenisMike 671 days ago [-]
Is there a list of the tests worth taking to get as full a view as possible into my health?
w10-1 671 days ago [-]
Quest Diagnostics, one of the biggest labs in the US, has a portal where you can order tests directly, including panels for wellness, allergies, etc. Descriptions are fairly general but accurate AFAICT. I've bought ~$1,000 worth over ~4 years with no real hiccups.
A lot of DTC lab testing is actually cheaper than rolling the dice with your insurance company
stainablesteel 671 days ago [-]
so are they selling this to health insurance companies?
acumenical 671 days ago [-]
Maybe the heart was in the right place, but yet another test that consumers pay for is not really the solution to the PFAS problem. The solution is holding polluters accountable. Until that happens, the test is simply a luxury that allows you to put distance between you and this worldwide problem.
mdrew 670 days ago [-]
Even if 3M/Dow etc paid out a trillion dollars tomorrow, we'd still have the health problems to deal with.
And those are managed by quantifying your risk and taking steps, if necessary.
azinman2 670 days ago [-]
It isn't an exclusive or situation. I'd like to know my own levels to then figure out if I should start donating blood to reduce, as well as avoid things like takeout boxes or any other potential source of PFAS.
NMS does not list consumers as their customers, and none of their customers make medical decisions based on their lab work.
NMS claims CLIA certification. This is the older law where labs self-certify compliance. Congress left CLIA in place alongside FDA IVD regulations to protect small pharmacists, but obviously Quest Diagnostics and LabCorp run fleets through that loophole, and most labwork is CLIA-certified, not FDA-approved.
Paying to test for highly-prevalent, possibly-toxic, pervasively-feared, under-studied chemicals is an ideal recipe for fleecing people with no real benefit.
Perhaps worse, if people get burned because it is corrupt, it puts people off trusting good providers. This is not just "Hey I made an app/web-site to track your period! How cool is that?" Some chemicals may be toxic, but so is fear.
So yes, it's super important to enable people to concretely understand their risks, protect themselves, and advocate for health policies. All the more reason to do it right.
So I hope you know what you're doing. Somehow the website needs to convey the organization behind it, and why that organization can be trusted to do this right, and not to mislead people.
This is highly misleading. CLIA and the associated federal regulations are the standard to which diagnostic clinical laboratories are held, not an "older" or "loophole" regulation. All laboratories in the US that provide patient results for clinical use are regulated by CLIA. There are FDA-approved test systems and "Lab-developed tests" (LDTs) that are BOTH subject to CLIA obligations, which are unbelievably complex (and in my opinion are a source of regulatory capture in laboratory medicine, but that's not directly relevant). Most high complexity lab tests are LDTs.
FDA-approved tests go through a formal FDA process such that the performing lab only has to "verify" the performance characteristics prior to patient testing. An LDT requires a much more stringent lab-level validation plan prior to patient testing. Both requiring strict ongoing quality control and quality assurance. And while the validation plan for an LDT can be self-designed, there are still strict requirements for what it most contain.
Compliance is NOT "self-certified," instead there are routine, extremely intensive compliance inspections (scheduled and unscheduled), either by a regional CLIA office, or by an organization accredited by CMS to provide such verification of compliance (such as CAP or COLA). These are not cursory inspections but a deep dive into all lab operations and personnel, equipment, maintenance and quality records, and other documentation.
I'm not a huge fan of Quest or Labcorp's presence in the field, and I don't know the specifics of NMS and this PFAS testing (CLIA compliance isn't required for research or non-clinical). If NMS has CLIA certification and they state the methodology and limitations of their LDT it's generally perfectly valid to provide the test, and the burden is generally on the downstream physician or provider to ensure the results are properly interpreted and applied.
Direct to consumer lab testing is offered in ~47 states in the country. It has been available for years with thousands of tests available. To date, there has been no apocalypse from empowering consumers to know about their own personal health.
NMS is one of the preeminent toxicology labs in the country. This test is Liquid chromatography–mass spectrometry which is known, quantifiable, extremely accurate and repeatable test methodology.
National Academies of Science, Engineering and Medicine explicitly references this lab in their report. Further, they go on to elucidate the risks and benefits of offering PFAS testing to people.
"Harms of PFAS testing include fear induced by blood draw, a small risk of injury or infection at the draw site, difficulties in interpreting results, and psychological stress that may occur when people who are tested learn that they or their family members have high levels of PFAS exposure. On the other hand, biomonitoring for PFAS blood levels may also alleviate fears associated with not knowing one’s PFAS levels. Another potential benefit is increasing awareness of exposure so that exposures can be reduced. If sources of exposure are identified, actions taken to reduce these exposures, such as using a water filter, may also benefit family members in addition to the person who was tested. Community-level benefits may be associated with PFAS testing as well, such as empowering communities to respond to contamination and providing a baseline with which to evaluate the impact of community-level interventions to reduce exposure. Additionally, biomonitoring for PFAS in the context of epidemiologic studies could provide more information about PFAS-associated health effects."
Also a couple of quotes from the same paper.
"Kristen Mello of Westfield Residents Advocating for Themselves (WRAFT) said to the committee:
You don’t have a problem getting an insurance assessor when your car is hit, you don’t have a problem getting an insurance assessor when you have a tornado, but this slow motion unfolding environmental and public health disaster … is intentionally keeping the information from us so that we cannot take action.
Furthermore, Emily Donovan of Clean Cape Fear, said:
Sadly it feels like guinea pigs are treated better, because at least their exposures are thoroughly studied for the betterment of humanity.
And Cathy Wusterbarth of Need Our Water said:
We’ve tested the fish; we’ve tested the deer; we’ve tested the groundwater, the waterways, and the foam. When are we going to test the people?… The only risk [of testing] is to the polluters who do not want us to link them to our exposure."
Make what you will.
Source: https://www.ncbi.nlm.nih.gov/books/NBK584705/
Consumers should always be allowed to do their own research.
So instead, the question is, if I pay $400 what meaning/value am I getting from this. And what can I get above and beyond the given 98% certainty I have that I've already ingested one of these chemicals?
I think it's right there in the post itself. If you have certain occupations, live in certain zip codes, or have medical problems, a test like this can prove invaluable.
If you're just curious, your mileage may very.
I do push back on the idea that not knowing is somehow better. Or people cannot handle learning new information about themselves. It's an old idea from medicine I hope we can move past as it just entrenches the power dynamic between caregivers and patients.
Invaluable, as in, worthless?
Invaluable for what? What are you going to do if you test positive?
If your level is significantly elevated (>20 ng/mL), you can audit your environment by testing your tap water and installing a reverse osmosis whole house filter (expensive). If your level is low, you don't need to do any of this. By eliminating point source exposure, your PFAS levels would naturally decline in time.
Lastly, I bring up therapeutic phlebotomy as interesting emerging research because it points in a concrete direction to something that is very actionable (pending more study).
Edit: grammer
Emerging research is not something actually concretely actionable for most people. Worse, because most people are "arm-chair experts" without clear guidance, your average person is more likely to harm themselves with doing their own research into things like this than otherwise.
For the additional thing about "reverse osmosis whole house filter" most people likely can't do afford to do this. Even if they can, there would need to be much better guidance here to have any certainty that someone wasn't selling you snake oil. The only things I can find on these systems in searches is that the companies that sell them recommend them, and won't even say they can filter out PFAs on their own, that's a major red flag to me that this is poorly regulated and likely dangerously marketed for things they can't do anything about.
A thought experiment, if I offer you two glasses of water, and tell you one has PFAs and the other doesn't how could you actually test that assumption? How could you have certainty in that test? I'm not saying it can't be done, but knowing what companies you can trust in a brand new space is not something obvious, and especially in a low-regulation space can be a major opportunity for companies to use meaningless words to try and convince you they're doing more than they are.
I had an insect exterminator come to my door and tell me the "eco" in their company name meant that they were eco-friendly with 0 data to back that up. They also said that all of their chemicals for killing animals were "plant-based" and didn't expand on that any further. Companies can make a lot of money making up BS terms to try and sell you the same thing you've been buying for years. That's a lot easier than finding a new thing to sell you.
But the thing with ordering your own tests is that it is not the only way to get these results. You can simply ask a doctor. They'll order it and help you understand the results and insurance can cover it. Depending on your insurance, that might be cheaper or it might not. There are pros and cons to both approaches mostly centered around how self-driven you want your care to be and whether or not you have a cooperative doctor.
But I would add a general word of warning - raw lab results do need some broader understanding of what the expected results are. They'll typically tell you what numbers are too low/high, but will not tell you what it means if you are outside those limits. For some things, being a slight bit out of the norms is a big deal. For others, unless you are at a few multiples beyond the limits, there is northing to fret over. Knowing which is which is critical to know how to react to test results.
I'm not saying you've gotta work with doctors - I'm saying that they do have a point that self-educated and self-diagnosed patients who learn the info off the internet are not always well-informed. If you are going to go the self-directed route for your health care, take the time to learn deeply and do it well.
It's a little like those ads to sell you a full body MRI. Most doctors recommend against them because you're likely to do more harm to yourself than they actually fix something.
If you're concerned about PFAS, live a healthy life and skip spending money on the testing. Live somewhere with PFAS in the water? Get a reverse osmosis filter. Replace your cookware with something that doesn't contain PFAS. Don't use storage containers for food with PFAS. Check your water bottles.
Then live your life, because until we change as a society, there is only so much you can do.
It's everywhere. We all have it. Why bother.
I think we now know there's no safe level of lead in the blood. If you have suspected exposure in 2023, doctors quantify your lead level through a blood test and if it's elevated, recommend a medical procedure called chelation to remove it.
With PFAS, the medicine is just starting to catch up to the horrors of the news cycle.
But I think in the future, PFAS contamination is going to be treated in a similar way to lead exposure. That is, medically.
But right now, it's easy to throw up ones hands and say, it's all fucked. Why bother doing anything.
Even in your OP, you said you didn't know what to do about it. Neither does the website say much other than basically "lawyer". If there is something I can do to help me, then there is a purpose to the test. This chelation you mentioned.
But again, this should be a "See a doctor first" situation. What are the risks of chelation? Is it safer for me to have PFAS than go through chelation?
The lawyers ( https://www.pintas.com/pfas-class-action-lawsuit/can-pfas-be... ) say there is nothing I can do. So I should sue.
The news says there might be a way soon ( https://www.nbcnews.com/health/health-news/new-way-destroy-p... ) to get rid of PFAS, but nothing about from the human body.
At least the EPA has some suggestions about how to reduce your risk: https://www.epa.gov/pfas/meaningful-and-achievable-steps-you...
PFAS will eventually (slowly) leave your body - focus on not getting anymore, not on removing it. I posted a comment with suggestions elsewhere in this thread.
We have some really old tech that can reduce your levels -blood letting. (... or donation).
PFAS crusader haha.
Edit: forgot the word water
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994130/
Also: better to save a life and either average down whatever PFA count they have, or bolster their blood volume so they can start producing their own lower PFA infested hemoglobin.
Lesser of evils, and kind of a win win: if everyone was blood letting for the safety and humanity of others.
(While also agreeing with those in the thread saying that high-PFAS donations are likely often better than no donations)
Based on the new clinical recommendations, my 10.86 ng/mL level puts me at elevated risk for preeclampsia (if I were a women/pregnant). Knowing that could mean my BP during pregnancy is more closely monitored, with a BP cuff for example.
Does it though? What will a pregnant woman do based on her results? Will having PFAS affect someone’s decision about becoming pregnant?
Pregnant women are going to monitor BP anyway. And the intervention is $100 for a BP cuff so that’s cheaper than the test. So we’re better off just recommending monitoring BP more closely than this test.
The value we provide: If people want to know, they can now know.
I also think not making the test accessible also has downsides.
What I mean is what would justify someone spending $400. The example of pregnancy is not a good one, as someone is better off just monitoring blood pressure (which is already common advice for all expectant mothers) for $100 instead of paying for this test.
I think value based healthcare is more important when people pay themselves.
Since there’s no intervention based on the results, it’s not a good idea for people until the results are actionable.
What you should not bother doing is replacing your cooking pans because PFAS does not come from that. (Nor does it come from food storage containers or water bottles.)
The first thing to do is avoid paper dishes, no paper straws or any other kind of compostable dishware. The are frequently sprayed with PFAS to make them waterproof, and unless you are buying them yourself and checking you have no way to know what kind they are.
Avoid snowboarding - snowboards (and skis also I think) are sprayed with PFAS to make them slippery. The snow in the area will be covered in it, so just don't do that kind of sport.
Check your outdoor clothing, and kind of breathable clothing that is also waterproof is most likely coated with PFAS to make that happen. This is not just rain jackets, but also active-wear advertised as "quick drying".
Add a carbon filter (any kind) to your drinking water, you don't need reverse osmossis, carbon works fine. And helps for tons of other things you don't know are in there - plus it tastes better.
As a general rule any time you see an object that should get soaked with water stay dry be careful!
>replace my pans
>Get a reverse osmosis filter. Replace your cookware with something that doesn't contain PFAS. Don't use storage containers for food with PFAS. Check your water bottles.
Oh, so all of that would be a good start for anyone and everyone.
The test can help to determine if something, like blood donation, might be a reasonable course of action for a specific person.
This is a great test and a worthwhile addition to our understanding of how prevalent these substances are within the the body.
Any reduction of PFAS in the blood would be beneficial as they are endocrine disruptors.
This falls into the “neat, but what can I do” category and at $400, someone really needs to be into self data.
I have never in my life seen a more flagrant and willful violation of HIPAA. It's the only time I have ever contacted my state AG or the HHS.
I understand the sentiment here, but it's like saying "you should definitely try and find and work with a more ethical political party than the [reader's choice: Democrats|Republicans]". Good luck! It's not likely to happen, even if we all wish otherwise.
Edit: grammer
Don't get me wrong, I would love to have a test available for PFAS levels. However I've previously been denied a test from the medical provider due to the issues I've outlined above. So I think it would be helpful to know if/how they have addressed this problem.
Standard male levels of testosterone are between 3-7 ng/mL.
Standard female levels of testosterone are between 0.1-0.7 ng/mL.
And you're over 10 ng/mL of this crap?
Even if this stuff is a fraction as bioactive as testosterone, having more of it might explain a few societal health trends.
Correlation v. causation isn't all that well known here.
/s
The bush that people are beating around is the question as to whether this stuff is affecting sexual expression of humans en masse.
https://en.wikipedia.org/wiki/3M_Contamination_of_Minnesota_...
Waitlist link: https://pfas.report/waitlist/
There's a whole saga of testing involved:
https://www.michigan.gov/pfasresponse/investigations/sites-a...
https://www.michigan.gov/mdhhs/safety-injury-prev/environmen...
I ended up receiving a few complete blood surveys in the process - comprehensive metabolic panel, hematocrit, cholesterol, testosterone, albumin, bilirubin, thyroid markers, and at least a dozen other medical terms that I don't fully understand, plus what's apparently a more comprehensive PFOA/PFOS study than this one, with dozens of varieties of PFOS/PFOA.
I had a total of 9.8 ug/L in my blood, after drinking water that was 78ppt PFOS for decades.
According to your link, there were tests done by the state in the past, were you unable to participate in those studies?
Your level was 9.8 ug/mL?
If so thats way way higher. I'm sorry.
Edit: grammer
Great. Another reason to regularly donate blood. And you don't even have to pay 399$!
> "Despite all the technical advances in modern medicine, in certain post-surgical situations, we do still rely on one of nature’s most primitive organisms – the leech – to assist us in achieving a good outcome,” says Rod Rezaee, MD, UH otolaryngologist and head and neck surgeon.
https://www.uhhospitals.org/blog/articles/2020/03/how-leeche...
That's what I was wondering, what do you do with this information? How do you narrow down where your exposure came from?
It reminds me of leaded gasoline in the 50s. It's everywhere. Everyone has it in their bodies. What now.
New regulations in California are banning this stuff in food packaging. And EPA just has new limits for tap water that are really aggressive.
So I think it's moving in a good direction.
Since my tap water isn't the issue, and I don't have any obvious other source of exposure, I'm currently focused on how to get out what's already in there.
So the question is whether they need the blood more than you did pre-transfusion. If they did, then you're still commiting a net positive. If not, then it serves them right for requesting a blood donation despite needing it less than did an individual who was ready to donate their own.
Unless the blood is going to research, in which case it is a net positive regardless.
Sorry, but that phrase really annoys me.[0] What does it actually mean?
[0] full disclosure: PhD in organic chemistry
These compounds are not literally "forever" but they have long half-lives once released into the environment, due to the strength of C-F bonds and due to pollutants partitioning into low-degradation-activity environments. For example, a certain compound may be degraded by ultraviolet light from sun exposure, but tend to adsorb to soil where it's shielded from light.
PFAS share a lot of characteristics with the earlier-known "persistent organic pollutants" like polychlorinated biphenyls:
- Polyhalogenated organic compounds
- Low acute toxicity
- Endocrine disruptor activity
- Low rate of natural breakdown in the environment
In fact PFAS of concern share so many characteristics with the historically known PoPs that I am not sure why they got their own phrase "forever chemicals." They don't actually seem to have longer half-lives than those PoPs known by the 1970s.
For further reading, here is a page on PFAS from the Stockholm Convention on Persistent Organic Pollutants:
https://chm.pops.int/Implementation/IndustrialPOPs/PFAS/Over...
And one from the Environmental Protection Agency:
https://www.epa.gov/pfas/pfas-explained
But we choose to use it because a lot of people don't know the chemistry but recognize this label.
Just being able to take blood tests in general to get a better sense of what might be going on can be so informative.
How can you interface with Quest diagnostics like this?
When you say that you are working to expand this to other locations what does this mean? Are you negotiating with other Quest labs?
The test is not approved by the FDA so why can they provide it?
Are you affiliated with the test provider or Quest in any way?
Quest doesn't do the analysis on this particular test - Quest and LabCorp both send them out to NMS Labs in PA who performs the lab work.
We have a doctor we work with and a Quest account.
In other states, testing has been laggard. Which is maybe why some states have "low" levels.
Link: https://pfas.report/waitlist/
Also, I would love to see a histogram of results among the general population, if that can be found in the literature anywhere. I think it would be helpful context for result interpretation and a useful addition to your FAQ.
My levels of PFOS was the highest, that's "Scotchgard". The house I live in has a very expensive reverse osmosis water filter on the tap so I don't think it's that.
I eat a ton of fish (like everyday) and recently read they are a significant source of PFOS exposure: https://pubmed.ncbi.nlm.nih.gov/36584847/
Some of the limitations of the test are you can't tell if this is past or ongoing exposure. Hence my desire to investigate phlebotomy.
PFOS has a half life of ~2.7 years so it could have been there for a while. Source: https://oem.bmj.com/content/75/1/46
Remember the cool ads in the 90s for pants that would repell water and dirt?
Would also be cool to have an opt-in for folks to share their report, location, etc for research purposes.
I went with Grin because they said it's PFAS free. Best I could do.
You are perfectly fine with PTFE dental floss - it has no reactive PFAS components in it.
PTFE, the material, does not contain PFAS in bulk form.
That's the end.
Floss, as a product, could contain any number of compounds related to the manufacturing, packaging and coating.
Kind of a "no shit" answer, and not a real solution - you're just transferring it to someone else. Probably some moral conundrum in there about how you are worried enough to get rid of your PFAS but are giving it to someone else.
https://www.questhealth.com
And those are managed by quantifying your risk and taking steps, if necessary.