Annual Health Check

[GarryP]

I will be having my annual health check later this month in Bangkok, which is covered by my employer but is limited to the following tests only: Physical examination, Chest X-ray, Urine Analysis, Complete Blood Count, Fasting Blood Sugar, Cholesterol, Triglyceride, HDL-C, LDL-C, SGPT, SGOT, BUN, Creatinine, AFP, EKG and Uric Acid.

 

However, I am considering adding a few more tests, which I will fund myself, but not sure which tests are appropriate for me. I had a PSA test and a testosterone test a few years ago and everything was fine so don't think they would be that important at the moment. BTW I am in my early sixties and have slightly elevated blood pressure which is well under control. I have no other underlying conditions (at least that I am aware of), am not overweight, and exercise regularly, i.e. at least 5 days a week. 

 

Any suggestions would be appreciated.

[Jim Blue]

Garry you seem so healthy that frankly maybe Thailand is not for you ! 

[mstevens]

I'd consider adding PSA. I get mine checked every year.

 

Fasting insulin is also one to consider. It can pick up insulin resistance before you become pre-diabetic or full on diabetic.

[Mike Lister]

HbA1C blood sugar test and TSH & T4 thyroid hormone tests.

[bkk6060]

Add PSA.  And, these health checks are basic you can get all those blood tests for around 1,000 b at a clinic.

And, if you care about your heart it needs to include a EKG and exercise stress test.  Also,  an abdominal ultrasound is a good test.

[Sheryl]

As  others said, add the PSA. I also suggest an Exercise Stress Test.

 

If the FBS comes back at all elevated you'll need to do an Hb1Ac so maybe just add it to begin with. 

[GarryP]

Thanks to everyone for the suggestions. 

[guru]

1 hour ago, GarryP said:

Thanks to everyone for the suggestions. 

If you decide to have the exercise stress test, don’t automatically panic like I did if the doc says your results are abnormal. I had an exercise stress test as part of my annual medical at Samitivej Sukhumvit and doc said abnormal. She said it could be a false positive but to cease all exercise until I had a CT scan at 25k and one just happened to be available that evening. Only way to rule out this false positive was this CT scan. I was as scared as anything and in my mind, I had no choice. Scan came back normal with 0% calcium in my arteries and the exercise stress test abnormality was ruled a false positive. 
My mate had the same false positive stress test and same clear CT scan result at an annual check up in a different hospital. 
Good luck with your check up and I hope all goes well. 

Edited December 11, 2023 by guru

[GarryP]

FYI, I had an ultrasound of the whole abdomen last year and the results were normal, with the exception of a slightly fatty liver. Should you have this test done annually?

[Mike Lister]

4 minutes ago, GarryP said:

FYI, I had an ultrasound of the whole abdomen last year and the results were normal, with the exception of a slightly fatty liver. Should you have this test done annually?

I think so,  its a very useful test.

[georgegeorgia]

 

 

And ..... Testereone & Estrogen

What's your testereone levels?

 

 

[GarryP]

19 minutes ago, georgegeorgia said:

 

 

And ..... Testereone & Estrogen

What's your testereone levels?

 

 

Testerone was 2.96 in November 2022. PSA was 0.690. Never had an estrogen test and it is not included in the list of additional available tests.  

[GarryP]

19 hours ago, guru said:

If you decide to have the exercise stress test, don’t automatically panic like I did if the doc says your results are abnormal. I had an exercise stress test as part of my annual medical at Samitivej Sukhumvit and doc said abnormal. She said it could be a false positive but to cease all exercise until I had a CT scan at 25k and one just happened to be available that evening. Only way to rule out this false positive was this CT scan. I was as scared as anything and in my mind, I had no choice. Scan came back normal with 0% calcium in my arteries and the exercise stress test abnormality was ruled a false positive. 
My mate had the same false positive stress test and same clear CT scan result at an annual check up in a different hospital. 
Good luck with your check up and I hope all goes well. 

I last took the exercise stress test in 2018 and the results were normal. But I will do it again this year. 

 

Actually, I do tend to suffer from white coat syndrome, which usually knocks my BP up, but I test regularly at home and it is within normal levels (I take amlodipine 5mg)  

[Sheryl]

2 hours ago, GarryP said:

FYI, I had an ultrasound of the whole abdomen last year and the results were normal, with the exception of a slightly fatty liver. Should you have this test done annually?

No.

 

Abdominal ultrasound is not recommended by any public health authority as a routine screening tool for the general population. It is highly likely to uncover incidental, benign conditions (e.g. kidney cysts, liver cysts) that in turn lead to unnecessary invasive procedures (exactly why the private hospitals like to include it in packages -- and why government hospitals do not).

 

Your blood tests include liver enzymes. If these are normal, that is  enough. If they are elevated then yes ultrsound would be logical next step.

 

Your blood work also includes AFP, a so-called marker for liver cancer. This too is not generally recommended (both false positives and false negatives are common) but they tend to do it in Thailand because, unlike in the West, there is a comparatively high incidence of primary liver cancer here. In addition, in Thailand they use a much lower threshold as the upper range of normal. So if yours comes back "high" do not panic. Good chance it is still normal by international standards.

[Sheryl]

1 hour ago, GarryP said:

I last took the exercise stress test in 2018 and the results were normal. But I will do it again this year. 

 

Actually, I do tend to suffer from white coat syndrome, which usually knocks my BP up, but I test regularly at home and it is within normal levels (I take amlodipine 5mg)  

Re the white coat syndrome, have them re-check your BP after 5 minutes, and do some slow deep breathing during that interval .

 

And also make sure they are using an appropriate sized cuff. I find I have to tell them to do this, even when the correct sized cuff is lying right there next to the machine,. Using too small a cuff will falsely elevate your reading.

[GarryP]

2 minutes ago, Sheryl said:

No.

 

Abdominal ultrasound is not recommended by any public health authority as a routine screening tool for the general population. It is highly likely to uncover incidental, benign conditions (e.g. kidney cysts, liver cysts) that in turn lead to unnecessary invasive procedures (exactly why the private hospitals like to include it in packages -- and why government hospitals do not).

 

Your blood tests include liver enzymes. If these are normal, that is  enough. If they are elevated then yes ultrsound would be logical next step.

 

Your blood work also includes AFP, a so-called marker for liver cancer. This too is not generally recommended (both false positives and false negatives are common) but they tend to do it in Thailand because, unlike in the West, there is a comparatively high incidence of primary liver cancer here. In addition, in Thailand they use a much lower threshold as the upper range of normal. So if yours comes back "high" do not panic. Good chance it is still normal by international standards.

Thanks.

 

FYI my FBS, which you mentioned in an earlier reply, has been between 100 and 105 for the past 9 years (102 last November), so I will have HbA1c test this time as you suggested. 

[Lacessit]

I don't see eGFR mentioned, unless it has another acronym. An important test of kidney function.

[GarryP]

4 minutes ago, Lacessit said:

I don't see eGFR mentioned, unless it has another acronym. An important test of kidney function.

Strange that it is not included in the list of tests covered by the office, and yet when I checked my annual health reports, a figure for my eGFR test is always included. 

[Sheryl]

GfR is calculated from creatnine. It is not a separate test, it is a calculation

[FruitPudding]

Thinking of getting a full check up done.

 

Where do you think is the best value for money place to go?

 

Does the Red Cross offer these check up programs?

[mstevens]

6 hours ago, FruitPudding said:

Thinking of getting a full check up done.

 

Where do you think is the best value for money place to go?

 

Does the Red Cross offer these check up programs?

 

I am not aware of the Red Cross offering comprehensive blood test packages. They do offer STD / HIV testing.

 

Why not go to one of the many labs and get a bunch of blood tests done? There are some incredible package deals with all of the main blood tests for less than 1,500 baht. The tests have a range and any tests which come back outside of range are marked. If you any are outside of range, you could take the blood test results to a hospital / specialist to look over for their thoughts and possible treatment plans.

Edited December 27, 2023 by mstevens

[scubascuba3]

On 12/12/2023 at 6:07 PM, Sheryl said:

GfR is calculated from creatnine. It is not a separate test, it is a calculation

One thing I've recently noticed, lifecare lab Creatinine results are off compared to Red Cross, look wrong, 3 wildly different readings since early 2022

[FruitPudding]

8 hours ago, mstevens said:

 

I am not aware of the Red Cross offering comprehensive blood test packages. They do offer STD / HIV testing.

 

Why not go to one of the many labs and get a bunch of blood tests done? There are some incredible package deals with all of the main blood tests for less than 1,500 baht. The tests have a range and any tests which come back outside of range are marked. If you any are outside of range, you could take the blood test results to a hospital / specialist to look over for their thoughts and possible treatment plans.

 

Yeah, I've found a very comprehensive package for 5000, but it's just blood and urine.

 

For an extra 5k, at a hospital, I could get that plus exercise stress test, stool examination, EKG, chest x-ray, and full abdominal ultrasound.

 

I think it could be worth paying extra. The blood tests are great, but I could miss out on something serious like blood in stool or blocked arteries.

 

I know the topic here says annual checkup,  but I'd probably not do this again for quite a while (depending on results), so I am looking for a very comprehensive screening.

 

[Sheryl]

16 hours ago, FruitPudding said:

Thinking of getting a full check up done.

 

Where do you think is the best value for money place to go?

 

Does the Red Cross offer these check up programs?

 

In what part of Thailand?

 

And which Red Cross Hospital or Clinic do you mean (there are several)?

 

How old are you? Any underlying risk factors or health problems that you know if? (affects what tests you should have)

 

 

[Sheryl]

10 hours ago, mstevens said:

 

I am not aware of the Red Cross offering comprehensive blood test packages. They do offer STD / HIV testing.

 

You are thinking of the Red Cross Anonymous Clinic. OP might be referring to one of several TRC hospitals. He has not specified his location.

[FruitPudding]

28 minutes ago, Sheryl said:

 

In what part of Thailand?

 

And which Red Cross Hospital or Clinic do you mean (there are several)?

 

How old are you? Any underlying risk factors or health problems that you know if? (affects what tests you should have)

 

 

 

Bangkok

 

Almost 40. 

 

No conditions. A bit overweight, not the best lifestyle. 

[Sheryl]

1 hour ago, FruitPudding said:

 

Bangkok

 

Almost 40. 

 

No conditions. A bit overweight, not the best lifestyle. 

I suggest

https://rsuhealth.com/product/ตรวจสุขภาพ-24-รายการ-standard-check-up-package-สำ/

 

And add on to it:

1. HB1Ac

2. Exercise Stress Test (will give an indication of your overall cardiac fitness as well as detect about 80% of coronary artery disease. Fitness aspect especially pertinent given obesity and lifestyle.)

3. PSA (mainly just as a baseline for future reference)

[scubascuba3]

31 minutes ago, Sheryl said:

I suggest

https://rsuhealth.com/product/ตรวจสุขภาพ-24-รายการ-standard-check-up-package-สำ/

 

And add on to it:

1. HB1Ac

2. Exercise Stress Test (will give an indication of your overall cardiac fitness as well as detect about 80% of coronary artery disease. Fitness aspect especially pertinent given obesity and lifestyle.)

3. PSA (mainly just as a baseline for future reference)

At lifecare Lab that package is 1,000 baht excluding dentist, eye checks and x ray, not sure how good or important they are

[FruitPudding]

2 hours ago, scubascuba3 said:

At lifecare Lab that package is 1,000 baht excluding dentist, eye checks and x ray, not sure how good or important they are

 

Interesting.

 

I don't really need the dental or eye checks just now. Had those done recently. 

 

Chest xray would be okay,  probably only a couple hundred baht elsewhere 

[GarryP]

2 hours ago, Sheryl said:

I suggest

https://rsuhealth.com/product/ตรวจสุขภาพ-24-รายการ-standard-check-up-package-สำ/

 

And add on to it:

1. HB1Ac

2. Exercise Stress Test (will give an indication of your overall cardiac fitness as well as detect about 80% of coronary artery disease. Fitness aspect especially pertinent given obesity and lifestyle.)

3. PSA (mainly just as a baseline for future reference)

Had an EKG as part of my annual health check. Last time I was diagnosed with sinus bradycardia and 1st degree AV block, the latter of which was a new one for me. However, this time there was no sign of the 1st degree thing. The Exercise Stress Test came back normal too. Waiting for the full report, but the doctor said everything looked okay apart from high BP, which was the highest it has ever been during a health check.  Not sure whether the cuff was too small as mentioned by you in an earlier post. However, the doctor told me that I should rely more on my home testing if I am doing it regularly. He also mentioned white coat syndrome, which is me to a T.