Testosterone molecule

False Positives

By Erik Bos•6 min read•

*you need to clean this up a lot.

Too much testing gives false positives (2025)

When I first started, I had questions, about doctors and the medical system. You have to remember I am coming from the outside, business side, and like you, certain things were very strange to me. I thought proverbs/adages/maxims like these made sense:

An ounce of preventative is worth more than a pound of cure What gets measured gets managed If you don’t make time for wellness, you’ll be forced to make time for illness A healthy mind in a healthy body You are what you eat

This makes sense because it can be applied to you as an individual, as a person, it makes sense because you are the most important person in your life, and ideally you would have your best interests at heart. But when applied to a system, a medical system where there are licensing bodies, tax, chemical companies, profit, jobs, and vested interests to keep the system perpetuating, profitable and growing, this kind of thinking, this common-sense approach to health, is best swept under the rug or its practicality besmirched to protect the system. We all tend to want to blame the person closest to us, because its not as abstract as saying big pharma is the bad guy and not as diffuse as if it was a singled-out person. Easier to blame the doctor, but even that is kind of sticky, with medical errors being the so called 3rd leading cause of death. • Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016 May 3;353:i2139. doi: 10.1136/bmj.i2139.[1][2][3][4]

Regarding testing, especially preventative. Number 1, patients at Plunge are going to get more tests, and our patients agree this is a good thing, better to see things if possible early than too late. Doctors are trained and are;

  1. very reluctant to give “excess” or superfluous testing
  2. told testing should not be done in absence of a symptom
  3. That a vast majority of the time these tests don’t yield a positive result (that the person has what they tested for)
  4. It ties up the medical system
  5. Yields false positives

Again- its not necessary the doctor is out to get you- this is just what was learned and told to them by “experts” and endorsed by people that can revoke and grant licenses- so they are beholden to them, and have to defer regardless what they think to those bodies or even customs. Let’s break this down.

  1. If you are paying via your taxpayer money in a public system or privately who cares- its your life, your money, the tests (blood or imaging) are not invasive. I believe prevention is cheaper for the person and the government in a publicly funded healthcare system. Quality of life matters too.

  2. Symptoms do not always present to the point where it physically starts to impede you in some way. Most cancers are “caught” only because the person feels so ill they go into see their doctor- and the doctor may be still hesitant to requisition testing.

  3. Good. Preventative testing should yield mainly negative results, if it does yield a positive result hopefully the condition can be in the still treatable stage, or at least monitored now.

  4. This is false false false- it assumes that the supply is finite. There will never be a new lab to start up. In the real market- it’s called supply and demand- in this case there would be more labs to meet the growing need, more competition leading to better pricing, more innovation to refine and produce better tests. In comparing Canada vs, the USA, the USA has far better testing and a wider variety of testing and labs. Canada has 2 major labs.

  5. Yes, plunge members and people who do testing will get more false positives than people who never test. This is my contention but from what I read the experts feel that telling a patient the test result resulted in a positive result causes more stress than no testing- better to keep them in the dark. Doing so causes more unnecessary tests and taxes the medical system- again experts are experting in economics. I also think doctors don’t want to deal with this. Most people will freak out, I want our patients to build some resiliency.

IF there is a false positive, we wi

The reason why doctors is that preventive testing, or testing in absence of a symptom, doesn’t yield positive result a vast majority of the time, and “worse” it is costly, ties up the medical system with these “extravagant” tests, and yields some “false positives”

Your approach is consistent: use testing to illuminate underlying imbalances, particularly inflammation, and then deploy a robust, personalized lifestyle and nutritional strategy as the primary intervention. The “prescription” is often a pair of gym shoes, cleaner food, stress reduction techniques, and targeted supplements, with pharmaceuticals used judiciously and when clearly indicated after foundational work. This resonates strongly with a proactive, health-seeking clientele.

-stress testing.

The challenge is determining which tests, for which conditions, in which individuals, at what intervals, actually lead to better health outcomes (living longer, or living better) without causing undue harm from the testing process itself. No test is 100% accurate (few have 100% sensitivity and 100% specificity). The likelihood of a false positive increases when testing is done in populations where the condition is rare (low pre-test probability). The “pre-test probability” is a key concept here. If the likelihood of a person having a disease is very low before the test, a positive result is more likely to be a false positive. Guiding Philosophy for Your Clinic: Empowerment through Education: Your primary role can be to educate patients about actual risks, how to minimize them, and how to support their body’s natural resilience and detoxification systems. Personalized, Not One-Size-Fits-All: Recognize that individual risks, exposures, genetics, and lifestyles vary. Focus on Foundational Health: Many of the body’s defense and repair mechanisms against environmental stressors are supported by core healthy habits. Judicious and Actionable Testing: Testing should lead to clear actions or informed decisions, not just anxiety or more questions without answers. Cost-Effectiveness and Value: Provide services that offer tangible benefits and are perceived as valuable by your patients. Strategies for Your Preventive Health Clinic: Comprehensive Intake and Risk Assessment: Develop a detailed questionnaire covering lifestyle, diet, home environment (water source, cleaning products, cookware), work environment, personal care products, stress levels, sleep, family history, and perceived exposures. This helps personalize advice and identify areas for potential testing or intervention. Education as a Core Service: Workshops/Webinars: On topics like “Reducing Your Toxic Load at Home,” “Nourishing Your Body’s Detox Pathways,” “Understanding Endocrine Disruptors,” “Choosing Safer Personal Care Products,” “Improving Indoor Air Quality,” “The Truth About Pesticides & How to Minimize Exposure.” Resource Guides: Curated lists of safer product alternatives, guides to reading labels, recipes for healthy meals, information on local organic food sources. One-on-One Counseling: To discuss individual concerns and create personalized action plans.

Iatrogenic Death: “Iatrogenic” means “caused by medical examination or treatment. testing (which carries its own risks), potential for misdiagnosis, unnecessary treatments with side effects, and the psychological burden of being labeled with a condition you don’t have.

PSA testing (Prostate-Specific Antigen): A raised PSA can be due to cancer, but also benign prostatic hyperplasia (BPH) or prostatitis. A “positive” PSA often leads to biopsies. Many men undergo biopsies due to elevated PSA who do not have clinically significant cancer. These biopsies carry risks of pain, infection, and bleeding. Lung Cancer Screening with Low-Dose CT: A high percentage of nodules found are benign (false positives for cancer), but they may trigger follow-up scans or more invasive procedures like bronchoscopy or biopsy to rule out cancer. Recent Studies & Vetting: Organizations like the U.S. Preventive Services Task Force (USPSTF), the Cochrane Collaboration, and various medical specialty societies (e.g., American Cancer Society, American College of Radiology) conduct systematic reviews of evidence. These reviews look at numerous studies, assess their quality, and synthesize the findings, including rates of false positives and subsequent interventions. Their recommendations are based on this vetted evidence. You can find these reviews and their data on their respective websites. They are generally very transparent about the studies they include. Feasibility & Current Work: Pattern Recognition: AI and machine learning are indeed being used to analyze large datasets (including EHRs and lab results) to identify patterns that humans might miss. This includes trying to improve the accuracy of diagnostic tests or identify individuals at higher risk for certain outcomes. Identifying Test Interferences: You’re absolutely right about substances like biotin interfering with certain lab tests (e.g., thyroid tests, troponin). AI could potentially help flag patients on such substances or identify novel interferences. Predicting False Positives: Researchers are exploring ways to use AI to better predict the likelihood of a test being a true positive or false positive by incorporating more variables than just the test result itself (e.g., patient history, demographics, other biomarkers). This is complex because a definitive “false positive” label often requires long-term follow-up or invasive gold-standard tests. Databases & Correlations: Building databases to track test results, subsequent diagnoses, and outcomes is crucial. AI can help find correlations, but researchers must still carefully design studies to determine causation and clinical significance. Challenges: Data Quality and Access: EHR data can be messy, incomplete, or stored in incompatible formats. Access for research involves significant privacy and ethical considerations. Defining “False Positive” Systematically: This requires a clear “gold standard” for diagnosis, which isn’t always available or straightforward. Causation vs. Correlation: AI can find correlations, but careful epidemiological work is needed to confirm that a correlation implies causation. Reproducibility: As you rightly demand, any AI model or finding needs to be rigorously validated and reproducible across different datasets and populations.

Specialized Testing (Based on Risk/Symptoms/Foundational Results): Heavy Metal Testing: If specific exposure is suspected (e.g., certain occupations, known contaminated water). Urine or blood tests are most common; be aware of the controversies and limitations of hair testing for systemic toxicity. Organic Acids Test (OAT): Can offer insights into metabolic pathways, gut health, and some nutrient deficiencies. Interpret with caution and in clinical context. Mycotoxin Testing: If mold exposure is a significant concern and symptoms align. Environmental Pollutant Panels: Can test for specific pesticides, VOCs, phthalates, parabens. These can be expensive and results may not always lead to clear clinical action beyond general avoidance. Focus on those with stronger links to health outcomes and actionable interventions. Genetic Testing (Limited & Actionable): Tests like MTHFR or COMT can give some insights into detoxification pathways, but lifestyle interventions (e.g., B vitamin-rich foods, stress management) are often beneficial regardless of genotype. Avoid over-interpreting. Crucial Point on Testing: Always discuss the “why”: Why is this test being recommended for this patient?

Focus on Lifestyle and Natural Detoxification Support: Nutrition Guidance: Emphasize whole, unprocessed foods, organic where feasible, cruciferous vegetables, herbs known to support liver function (e.g., milk thistle, turmeric – with appropriate cautions), adequate fiber, and hydration (with filtered water). Gut Health: The gut is a major detoxification organ and barrier. Programs to support gut health (probiotics, prebiotics, gut-healing foods) can be beneficial. Sweating: Encourage activities that promote sweating (sauna, exercise) as a pathway for some toxin elimination. Stress Management: Chronic stress impairs detoxification. Offer resources for mindfulness, meditation, yoga. Sleep Optimization: Essential for cellular repair and detoxification. Movement/Exercise: Improves circulation, lymphatic drainage, and overall health. Guidance on Reducing Exposures (Practical & Actionable): Water: Recommend good quality water filters. Air: Air purifiers, opening windows, choosing low-VOC paints and furnishings. Food: Washing produce thoroughly, choosing organic when budget allows (focus on “Dirty Dozen” list), avoiding canned foods lined with BPA. Personal Care & Cleaning: Help patients identify and switch to non-toxic alternatives. Cookware: Advise against Teflon/non-stick PFAS-coated pans; recommend stainless steel, cast iron, glass. Profitability & Cost Management: Package Deals: Offer packages that combine consultations, select testing, and educational workshops. Membership Models: For ongoing support and access to resources. Careful Test Selection: Partner with reputable labs. Don’t order every conceivable test for every patient. Be selective and justify each test. The markup on tests can be a revenue source, but ensure the tests provide genuine value. Focus on High-Value Services: Education and personalized lifestyle plans can be incredibly valuable and have lower overhead than extensive testing.