Dubious blood testing at the fringes of medicine

As I was doing followup research to make my final decisions on which blood tests to take as part of my self-tracking project, I stumbled upon some difficulties.

I was deciding between two labs for one particular test, one of which had a sketchy-looking logo (Doctors' Data).  I typed its name into Google, and Google suggested the auto-complete "Doctors Data fraud".  Oh my.  I spent a good bit of time poking around for the next couple of hours, and learned a lot of disturbing things. 

Apparently there are certain tests at certain testing labs that are commonly known to produce "abnormal" readings for just about everyone who takes the tests.  Scam nutritionists and other shady alternative medicine practitioners know this and will tend to use these companies to produce official-looking documents to back up their claims to the patients.  (Every lab that the Scientologist nutritionists at HealthNOW used is on the list)  There's plenty of morally conflicted economic self-interest going on.   Apparently there was a big lawsuit a while back, when a toxic metals test with poor methodology led a woman to choose a dangerous chelation therapy that killed her.  

It's hard to tell how far I should let this mistrust spread.  Only one of the tests I was considering (the IgG/IgE food allergy test) is on the list of dubious tests.  However, should I not trust other tests from the same lab?  Should I not trust Direct Labs for offering these tests, or should I think of them more like an Amazon that offers everything for sale, good and bad.  Can I trust the site (quackwatch) that has come up with the labs-not-to-trust list, or is the site's owner being too reactionary?  It's kind of maddening, like this picture except less funny:



I think I'm going to pull back on the couple of tests from Metametrix and Genova that I was considering, but I'm going to keep the bulk of the remainder.  If many labs offer a particular test (and they're not just rebranding a third party lab's test), it's probably a legitimate test.  In addition, if I get results from a test that imply that I should do something radical, I'll talk with a doctor and have the test redone by different labs.  I should also accept that some of my money in doing these tests will likely be wasted, and some of the changes I make will be pointless, but on the whole it's most likely still a lot better than doing nothing. 

Seth Roberts' self experimentation manifesto

Seth Roberts has been doing self-experimentation for a couple of decades on top of his professional professorial pursuits.  He recently wrote up the fascinating article "The Unreasonable Effectiveness of my self-experimentation", which states:

Over 12 years, my self-experimentation found new and useful ways to improve sleep, mood, health, and
weight. Why did it work so well? First, my position was unusual. I had the subject-matter knowledge of
an insider, the freedom of an outsider, and the motivation of a person with the problem. I did not need to
publish regularly. I did not want to display status via my research. Second, I used a powerful tool.
Self-experimentation about the brain can test ideas much more easily (by a factor of about 500,000) than
conventional research about other parts of the body. When you gather data, you sample from a power-
law-like distribution of progress. Most data helps a little; a tiny fraction of data helps a lot. My subject-
matter knowledge and methodological skills (e.g., in data analysis) improved the distribution from which
I sampled (i.e., increased the average amount of progress per sample). Self-experimentation allowed me
to sample from it much more often than conventional research. Another reason my self-experimentation
was unusually effective is that, unlike professional science, it resembled the exploration of our ancestors,
including foragers, hobbyists, and artisans.

His points about rapid iteration of hypotheses and the power-law distribution of scientific progress are fascinating.  The modern scientific environment makes the use of human intuition through play much more difficult.  (Among other things, no animal subjects ethics board would let you have some mice to "play" with.)  He also makes some great points about how medical researchers who do not have contact with patients are less likely to make practical breakthroughs -- I've noticed similar issues occur in companies, where engineers and other employees who do not meet with customers regularly often end up making less useful features than those who do.

Seth also points out that it's likely doctors will decline in their role as gatekeepers, a trend I would agree is likely to happen.  This may lead to more quack medicine and other issues, but I believe alternate reputation systems can be developed to handle these concerns.