“It says here you drink four or more cups of coffee a day. Do you feel like you really need that much?”
Yes. Yes, I do, thank you very much.
I’m on the phone with a doctor in Sacramento. He’s looking at the results of the blood-chemistry tests I recently commissioned through WellnessFX, along with some health and nutritional data I entered into the company’s website.
This particular doc has a holistic bent, and he’s wondering whether I might be eating or drinking something that’s unbalancing my immune system (I have a longstanding autoimmune condition called psoriatic arthritis). He thinks the same irritant might be contributing to the higher-than-normal cholesterol levels showing up on my chart.
“If I were you, I’d want to find a naturopath to evaluate you for food sensitivities,” he’s saying. “If they found something, you could potentially decrease some of the inflammation in your body. Any excess inflammation could be contributing to higher levels of cholesterol than you’d expect.”
In the last few years, as I’ve hit my mid-40s, I’ve stopped eating meat, sworn off dessert (mostly), and become a marathon runner. But as much as I respect where this doctor is coming from, I’m not about to give up coffee. Cheese and cereal, maybe. But I don’t think I could be a proper writer without my daily half-gallon of caffeine.
So I’m listening carefully to the doctor’s advice, and taking lots of notes. But the bitter seeds of non-compliance are already sprouting in my head.
And I’m worried that this feeling, writ large, is one of the stumbling blocks that could limit the effectiveness of online personal-health services like the one WellnessFX is trying to build.
The San Francisco-based startup, which is backed by $5.8 million in venture funding from Javelin Venture Partners, Floodgate, Voyager Capital, and Health Tech Capital, provides customers with private, personalized assessments of their blood chemistry and summarizes the results using colorful, easy-to-understand online charts. For $199 you can order a diagnostic panel that goes way beyond the tests your primary care physician would normally request.
You’ve probably had your HDL (“good cholesterol”), LDL (“bad cholesterol”), and triglyceride (fatty acid) levels checked at least once—but WellnessFX also measures a bunch of other important-sounding quantities, such as Lp(a), Apo B, hs-CRP, TSH, glucose, HbAIc, BUN, creatinine, AST, ALT, total bilirubin, albumen, total protein, Vitamin D, sodium, calcium, potassium, and CO2.
The WellnessFX fee also includes a 15-minute phone consultation with a licensed medical doctor, like the one I’m doing now.
I’ve scored in the green zone on everything except cholesterol and Apo B, so that’s what my advisor is focusing on. From what he’s saying, it sounds like figuring out whether I’m really sensitive to wheat, dairy, coffee, or other foods is going to require some office visits, some time, and probably some serious out-of-pocket costs. So I’m not in a huge rush to investigate further.
I suggest to the doctor that maybe I could just take bread or milk out of my diet and see how I feel. “That’s problematic because we’re talking about cellular changes here,” he says. “For example, you couldn’t tell me, based on how you’re feeling, that you have high or low cholesterol.”
Basically, he’s saying that I’m going to need professional help adjusting my diet, and I’m going to have to go back for repeated blood tests to see if it’s working.
And there’s the rub. If you’re really proactive about your health, you can pay out of pocket for a WellnessFX screening, as I did. Or if your benefits package happens to include a really excellent wellness plan, you can get your employer to pay for it. But that’s just the first step on what can easily become a very long road. How many people have the will, and the wherewithal, to go down it?
It may be that this brand of self-testing can greatly improve health outcomes in the long run, and that there’s plenty of room for personalized health startups like WellnessFX to succeed. But I can’t help thinking that we need to work out some big social, economic, and political questions first. Like whether consumers who want to radically change their own health habits can expect much support from their traditional doctors and insurers, to name just one.
I got some insight into how WellnessFX thinks about this stuff from CEO Jim Kean last week. I’d had my blood drawn the week before as part of the research for the interview, and ironically, I was bleeding again when I showed up at his office. (My bike chain had come off during the trip over, and my finger got caught while I was fixing it. But the nice folks at WellnessFX bandaged me up.)
I asked Kean, to start, why WellnessFX provides such a large panel of diagnostic tests. “About 70 percent of the information you need to understand your current state of health resides in your blood and urine,” he answered. “At an average physical you might get total cholesterol, HDL, LDL and triglycerides, but the things that are far more predictive are
