Function Health: The Missing Half

The "quantified self" trap

You just paid $499. You gave 15 vials of blood at a Quest Diagnostics in Center City. You now have a dashboard with more than 100 biomarkers.

Now comes the hard question: I still do not feel right. What do I do with all this information?

I see this every week in my Fishtown practice. Patients sign up for Function Health, or similar services like InsideTracker, because they are tired of standard care ignoring their curiosity. I respect that. But data is not medicine. Data is just noise until someone applies clinical reasoning to it.

Function Health does not know your symptoms, your family history, or your story. And your story matters.

Labs give the map. We drive the car.

Feature	Function Health (the dashboard)	Fishtown Medicine (the doctor)
The "what"	"Your ApoB is 110 mg/dL (high)."	"We need to lower this below 60 mg/dL."
The "how"	Generic auto-suggestions ("eat less saturated fat").	A specific strategy: "Let's start Repatha and re-test in 8 weeks."
The insight	Flags values outside the lab's range.	Finds the hidden yellow flags inside the "normal" range.
The power	Observation.	Prescription authority.

Guidance from the Clinic

"I love it when patients bring me proactive data."

My perspective: please bring me the PDF, your old medical records, and your full story. Instead of spending our first appointment ordering labs, we spend it building your plan. You saved money on the labs. Now invest that savings in the relationship that fixes the problems.

What advanced markers do we look for?

Function Health tests for things most primary care doctors in Philly do not run. When you walk into my office with these specific markers, we can get to work right away.

1. Lp(a): An inherited cholesterol marker that raises lifetime heart risk. If yours is high, we manage every other risk factor more carefully.
2. ApoB: The direct count of cholesterol-carrying particles, a clearer signal than LDL alone.
3. Homocysteine: A B-vitamin marker that tells us if you might benefit from methylated folate or B12.
4. Free T3: The active form of thyroid hormone, which gives more information than TSH alone.

How do you use Fishtown Medicine alongside Function Health?

You do not have to pick one. In some cases, you may not need to pay for the other at all.

1. Have not ordered yet? Use the insurance route. If you have not done your Function Health labs yet, we can often get the same advanced biomarkers covered by your insurance. We order the same tests through Quest or LabCorp, billed to your PPO. You get the data without paying out of pocket.

2. Already have data? Use the strategic route. Join us as a member and upload your PDF to our portal. We treat the results as the foundation of your chart.

3. We execute on the data.

   • I confirm which flags matter and set the noise aside.
   • I order the follow-up imaging (CTA Coronary, ultrasound) that Function Health cannot order.
   • I write the prescriptions (statins, PCSK9 inhibitors, hormone therapy, continuous glucose monitor) that Function Health cannot write.

Data is potential. Action is power.

Scientific References

1. Sniderman AD, et al. Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiology. 2019. Evidence supporting ApoB as a sharper cardiovascular risk marker than LDL alone.
2. Tsimikas S. A Test in Context: Lipoprotein(a). Journal of the American College of Cardiology. 2017. Clinical interpretation of Lp(a).
3. Smith GD, Ebrahim S. "Mendelian randomization": can genetic epidemiology contribute to understanding environmental determinants of disease? International Journal of Epidemiology. 2003. Background on causal inference in cardiometabolic risk.
4. Welch HG, Schwartz LM, Woloshin S. Overdiagnosed: Making People Sick in the Pursuit of Health. Beacon Press, 2011. Critique of over-testing without clinical context.