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Launch HN: Be Golden (YC S22) – Measure and manage your inflammation levels
223 points by Snehpatel1 on Aug 30, 2022 | hide | past | favorite | 154 comments
Hi HN! This is Sneh and Kimberly from Be Golden (https://www.begolden.online/). Be Golden helps you understand how your lifestyle impacts your health, particularly in terms of inflammation levels. I (Sneh) am a PharmD and the CEO; Kimberly has a PhD in biology and is the CTO.

We all make lifestyle choices daily - what we eat, how much we exercise, etc. No matter how good we are, we are all probably trying to get better but we don't have a great feedback mechanism on how our choices impact our health. We may go to the doctor once a year (if that) to get some blood work done but so much happens in between that it's hard to tell what made an impact. We wanted to change that so that you are better understanding how your lifestyle is impacting your health to help you make better decisions.

Be Golden focuses on helping you measure and manage inflammation levels because inflammation is impacted by all key lifestyle behaviors (nutrition, exercise, sleep, stress) [1] and impacts a variety of health outcomes—from energy levels, to IVF success rates and IBS symptoms to chronic diseases like heart disease and cancer [2]. This Nature Medicine article (https://www.nature.com/articles/s41591-019-0675-0) states "One of the most important medical discoveries of the past two decades has been that the immune system and inflammatory processes are involved in not just a few select disorders, but a wide variety of mental and physical health problems that dominate present-day morbidity and mortality worldwide."

I started tracking my inflammation scores (see my graph here! - https://www.begolden.online/post/our-ceo-s-hscrp-scores-over...) after I learned I was at high risk of breast cancer and had a bilateral lumpectomy. I learned that chronic inflammation can be a driver of tumor development [9], progression [10], and treatment responsiveness [11]... and can impact a surprising number of other things. It keeps us from functioning optimally. The good news is that it can be managed with healthy lifestyle choices (see [1]). I started making healthy changes (like exercising almost daily) and seeing an impact on my inflammation levels (although it seems like the “startup lifestyle” has me back on an upswing lately). I decided to start a startup to help manage inflammation because I wanted more tools, data and analytics to help me make healthy lifestyle choices. I recognize the (hopefully short term) irony :).

So how does it work? You start by measuring your baseline inflammation levels using an at-home, finger prick based, blood testing kit, that includes a shipping label to send the sample back to the lab. You then receive your lab results and we start layering in data-based insights like how your levels compare to other people like you. From there, you can try a new habit from our list of scientifically backed options (https://www.begolden.online/post/lifestyle-interventions-ass...) or something else you have been meaning to try.

Once you choose a habit (for example, adding ginger to your diet), we will help you track how often you do it. Our current digital platform design is to text you daily and ask you: Did you have ginger yesterday? (yes/no). Then you will re-measure and receive insights. For example, you may get an insight like - you have had ginger 15 of the last 30 days and your inflammation levels are down 10%. Based on the data from clinical studies, some interventions can change inflammation levels (as measured by hsCRP) within weeks and others show within months [3]. As such, we recommend testing every 1-2 months to likely provide adequate time for change to your levels. Each person’s needs and time to impact will vary, so you can adjust this frequency up or down, depending on what works best for you.

Note - You can of course request that we delete your data at any time and we’ll do so.

We measure inflammation using high sensitivity C Reactive Protein (hsCRP), an established marker of systemic inflammation [4].

For those not familiar, I thought I would also share a bit about what inflammation is. There are two types of inflammation—acute and chronic. Acute (short-term) inflammation is beneficial [5]. It can be caused by infections as well as cell damage. During acute inflammation, the immune system ramps up, removes pathogens/heals tissue then ramps back down [6]. In chronic inflammation, something other than acute infections (like physical inactivity, obesity, and/or disturbed sleep) may be driving inflammation and the process doesn't ramp down so the immune system is constantly active. This constant activation may lead to the immune system attacking healthy cells, draining energy, and losing normal functionality [7]. Chronic inflammation can disrupt homeostasis [8], which is when the body is in balance and functioning optimally.

In the future, we should be able to let you learn from not only your own data but data from others (anonymously, of course). For example, you may be able to see what interventions have shown the greatest impact among people like you. By bringing more people and interventions to the platform, we can improve the experience for everyone.

We’ve recently been building a tool to help you see how different lifestyle choices can impact inflammation scores among different demographics, based on aggregated data. Check out our “work in progress” tool here: https://begolden.shinyapps.io/shinyapp/ - we’d be interested in what you think of it!

If you’re interested in your inflammation levels, you can pre-order Be Golden here with a special HN discount code HACKERNEWS to receive the first test and access to the digital platform for just $59: https://www.begolden.online/ If you are not ready to order and just want to learn more, you can do so at the same link.

We’re looking forward to hearing any of your comments, questions, ideas, experiences, and feedback!

p.s. dang suggested we put all the footnotes in a comment because there are so many of them - so they're here: https://news.ycombinator.com/item?id=32650321.



First: Congrats on attacking this space. I think there is all sorts of need in the self-managed care world.

That said (you just knew there was going to be criticism :)

> Overall, we recommend healthy lifestyle habits versus drugs to manage inflammation levels.

Such a blanket recommendation strikes me as problematic: Which "lifestyle habits" handle the case where CRP is high due to things like (say) cancer? Or mold-toxicity? Or auto-immune issues?

In constructing the company, I assume there is a general counsel talented in medical liability, which strikes me as a minefield. I also assume the very public history of Theranos is also going to invite interesting scrutiny, even though you're running a legitimate operation.

Good luck to you in any case. Self-managed care should be an interesting space over the next decade imho.


> Or auto-immune issues?

N=1, but I have an autoimmune disease that has reacted extremely well to lifestyle (stress & diet) changes after years of expensive drugs failing. Or regression to the mean happened. Or a recent solar flare fixed what was wrong with me. Nobody knows.

Doctors are great but they’re overworked and the amount of time required to truly help patients isn’t feasible. When science doesn’t have any easy solution to your problem self care (or tons of money) is the only option - which makes it awesome to see products like those in the OP! Hopefully it’ll be a step up from a lot of the snake oil self care out there.


This! x100! Thank you for sharing your journey


> This! x100!

You can't turn N=1 into N=100 just like that ...

I do hope someone will keep an independent scientific record of how this approach actually helps people (if at all).

There's a lot of money being made in the space of nutritional supplements at the moment, and yet there is very little evidence that any of them work at all. We shouldn't let the same happen here.


>> This! x100! >You can't turn N=1 into N=100 just like that ...

You're right - I probably shouldn't have used the language I did. In retrospect I see how it was confusing. I just meant to express how happy I was that healthy lifestyle changes were helping someone. :)

> I do hope someone will keep an independent scientific record of how this approach actually helps people (if at all).

Yes! We want to contribute to the scientific literature (e.g., by identifying new lifestyle interventions that help reduce inflammation levels) and do so in a validated way!

In the meantime, we base our service on existing scientific literature regarding which lifestyle interventions are associated with decreased inflammation levels: https://www.begolden.online/post/lifestyle-interventions-ass...


Can I ask which autoimmune? I have one too and so far have been relying on drugs but want to try this inflammation / lifestyle approach.


Not GP, but try an elimination diet. I had chronic sinus headaches and cutting out a ton of foods fixed it. My brother is diagnosed celiac, I am not because you have to eat gluten for the blood test or do a stomach biopsy, both of which I'm not down to do.

Changed my life in such a significant way. Doesn't hurt to try it.


:) I love the questions - they help us improve!

You are correct that there are sources of inflammation that are not lifestyle related, but many of the drivers of inflammation are indeed lifestyle related.

I really like this article on the drivers of inflammation: https://www.nature.com/articles/s41591-019-0675-0

I particularly like Figure 1


I also thought I would share our blog on lifestyle interventions associated with decreased inflammation levels:

https://www.begolden.online/post/lifestyle-interventions-ass...


I'm not against using it, but isn't technically using garlic, curcumine a sort of natural medication, more then a lifestyle change? They are both aryuvedic methods. Curcumine for sure.


Curcumin is one of the main ingredients of (e.g.) Indian cuisine. Does it mean that the nation is comparatively less inflamed?


Historically? Yes, actually.

There has been a surge in, for example, IBD in India recently [1], but by and large India did not have many of the inflammatory disease issue we had for decades. They had plenty of other diseases, but I wouldn’t be surprised if all the curcumin helped stave off certain inflammatory conditions.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988149/


Also as someone with an AI condition the baseline inflammation levels from lifestyle are important. If I eat lots of junk food it'll trigger my AI even with medication.

I'm excited by your company, and will certainly be checking it out. Are there options for more regular testing? I'd like to establish baselines on my week to week or even day-to-day. I just dont want to figure out a lab to do my own testing.

Best of luck!


Hi! Yes, you can test more frequently. Once you choose a plan, you can add as many more tests as you like at that same cost per test.


I’m heavily involved in the auto immune communities.

Eventually many people get the point that they realize diet alone can either dramatically reduce or eliminate symptoms.

Will it work 100% of the time, no.

Something like the autoimmune protocol diet is amazing at calming down inflammation.


Theranos is so huge in some people's minds because it billed itself first as a Silicon Valley style tech company, so people associated with Silicon Valley style tech companies are well aware of it.

There have been tons of companies doing things far more similar to Theranos' claims especially in the liquid biopsy space, without any negative association, partly because they bill themselves as biotech companies, and partly because their tech actually works.

The main reason Theranos was able to get away with what they claimed, was people in the industry knew what they claimed was approximately possible, just hadn't yet been done with the tech of the day.

11 years later, that tech has continuously improved. Biotech companies with interesting ideas about how to approach liquid biopsy and personalized medicine don't get extra scrutiny because of Theranos. The exception is if they are going for funding to people more familiar with Theranos than with biotech. Which is itself as much of a red flag as one needs.


> was people in the industry knew what they claimed was approximately possible, just hadn't yet been done with the tech of the day.

Everyone I know in the industry has always said that what they claimed was physically impossible, tech be damned.


There's a bunch of companies that promise impossible things like wireless power (ubeam), or super high bandwidth radio (femtocell), or handheld spectrometers that tell you how many calories are in a dish (don't remember the name).

For some reason parts of the tech community always fall for this bullshit.



> Some of the ways we market to you include email campaigns, custom audiences advertising, and “interest-based” or “personalized advertising,” including through cross-device tracking.

> Advertising Partners. We may share your personal information with third-party advertising partners. These third-party advertising partners may set Technologies and other tracking tools on our Services to collect information regarding your activities and your device (e.g., your IP address, cookie identifiers, page(s) visited, location, time of day). These advertising partners may use this information (and similar information collected from other services) for purposes of delivering personalized advertisements to you when you visit digital properties within their networks. This practice is commonly referred to as “interest-based advertising” or “personalized advertising.” APIs/SDKs. We may use third-party Application Program Interfaces (“APIs”) and Software Development Kits (“SDKs”) as part of the functionality of our Services. For more information about our use of APIs and SDKs, please contact us as set forth in “Contact Us” below.

This is a bummer. Can no company exist without Facebook and Google Pixels?


Congratulations on your launch! I apologize in advance for my ignorant questions, but here they go.

How can we be certain that inflammation is causing problems rather than just being an indicator that something is wrong? As in, if we start directly lowering inflammation with some drug or whatever, how do we know that it's helping rather than just masking the problem? So if someone is obese and inactive, but they start eating ginger to reduce their inflammation markers, would that improve quality of life?

I guess the best example(as someone that is completely ignorant on the topic) I can come up with is heart rate and exercise. We know that an elevated heart rate when exercising is good and provides benefits. But increasing the heart rate with caffeine does not provide the same benefits.

Coming from software where I can use a debugger to examine "exactly" what is going on in a program and an ex hardware engineer where we had simulators/models that were "pretty accurate", medicine/healthcare looks insane. We cannot model the human body accurately nor can we observe in great detail the processes that go on. I'm pretty amazed medicine is as good as it is with those limitations.


The body is nuts. Fascinatingly and amazingly nuts.

I think an honest answer to your question is "we can't be certain". In fact we can probably be fairly confident that "inflammation" (as if that's one simple thing) is not going to be quite so straightforward.

A person who is obese and sedentary might get some benefit from a "magic drug" that prevents the effects of inflammation, but they'd be far better advised to adopt a more active lifestyle before they put their hopes on ginger.


I will now apologize in advance if I am not answering the question :)

Overall, we recommend healthy lifestyle habits versus drugs to manage inflammation levels.


This is like 10x the cost of other hsCRP tests you can take from home.

Pretty hard to justify the cost differential.

Also, going to a proper doctor and having a real blood test done once a year would cost way less than this.


I'm obviously not in the target market but apparently I can get the test for 450 INR or 5.65 USD. This is includes a trained phlebotomist coming to my house to take the sample: https://www.1mg.com/labs/test/High-Sensitive-CRP-2274


This is helpful to know as we look into international expansion.

Our current pricing is in the US market. Hopefully, costs decrease over here over time!


I believe our prices are in line with other at home tests. Would you mind sharing any links you have that have pricing 10x lower? I'd love to look into it and see if we can bring our costs down for our customers!


I found this one https://www.ultalabtests.com/test/cardio-iq-hs-crp for $30 something.

Usually they are anywhere between $50 and $90 on everlywell and letsgetchecked I think.

You're right on the money at $74 I think but I will steer clear due to this $60/year digital platform subscription that kicks off after year 1.


We made it optional to auto-renew the subscription. Hope you give us a try!


Some quick research shows these tests can be ordered by the patients, themselves, for ~$60, so the same as the disccounted/offer price here.

LabCorp: https://www.ondemand.labcorp.com/lab-tests/inflammation-hs-c...

Quest: https://questdirect.questdiagnostics.com/products/crp-inflam...


The whole point is that the test is part of a system to put the results in context, more frequently that an annual visit. My doctor isn't very good and has never brought up or tested me for this.


Not going to argue with the price, but monthly / biweekly / weekly testing is way different than once a year. Yearly is enough to get an overall sense of where you are at, biweekly lets you correlate w/ much more fine-grained signals. Plus it keeps the score in your head as a goal.


> proper doctor and having a real blood test done once a year would cost way less than this.

how much is that?


Not sure about other countries but this is completely free in Australia. It's a general consult and bulk-billed onto medicare.

I get an annual blood test done, even if not in the country, have paid $30 in Europe and $20 in Asia as a foreigner, isn't even worth bothering to claim on overseas health insurance.


That seems correct to me. I tried to look up the costs in Australia and I think this is the Medicare Benefits Schedule for it (ie C-reactive protein), though I'm happy to be corrected if I'm wrong:

http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=66...

If correct, it seems the cost to the taxpayer is $9.70 AUD (about $6.67 US). So even without bulk-billing making it free here, that's still a 10x markup.


Thanks for this info, particularly as we look to expand internationally :)

Our price includes lab costs but also the cost of the packaging, shipping, ordering physician, etc. which all starts to add up!

We decided to start with at home kits for the convenience but are planning to explore other methods of measuring levels (e.g., partnering with physical labs)

Edit: I should also add that costs/prices typically start higher with startups and we fully expect them to come down as we scale.


Most insurance plans see this as preventative care to get bloodwork done when you're doing your wellness visit, so, if you have insurance, $0 out of pocket.


In my experience, some doctors won't order hsCRP (the marker we measure) for everyone. If they do, I think it would be rare for insurance to cover it multiple times per year.


Why do we need it multiple times per year? Maybe that's the part that needs to change, so as many people as possible have access to the data?


The idea is that by testing multiple times per year, you get more insight into what may be driving your levels and be able to intervene sooner


As someone with an auto-immune disorder, i've managed to reduce inflammation with diet changes, but it is always an ongoing battle against various triggers.

Something like this would be great to help me monitor inflammation levels and correlate that data with lifestyle changes (did I eat gluten that week as a cheat? Did I have some milk or chocolate?)

There's so many lifestyle changes I make that "appear" to reduce inflammation but there's no real way to monitor the effectiveness of those changes on inflammation markers.

I know, for example, a primary trigger for me is a pet allergy that triggers a general immune response, which in-turn raises my baseline inflammation and then causes the auto-immune issues. One pet exposure and i'm a wreck for weeks.

Being able to track this, and see if antihistamines impact the inflammation ect is helpful.

My condition isn't serious enough to warrant immunosuppressive treatment, and heavy steroids are overkill.


I monitor my hs-crp quite regularly (multiple times a year).

1. How is this different from a test you can order?

2. hs-crp is quite variable, especially for people who are predisposed to inflammation. I really don't know if I can make any sense of it [1]. Given that the plans on your website (but not this HN post) suggest a lower frequency than my own testing, I'm a bit skeptical of this product (or service).

> For example, you may get an insight like - you have had ginger 15 of the last 30 days and your inflammation levels are down 10%.

You have no proven numbers or data, and you're just saying you MAY find a correlation. Have you published anything that validates the efficacy of your product, other than an experiment with N=1?

[1]: Edit/Add - From your own tracking sheet, how can you tell whether the first 2.9mg/L in your graph is not an outlier, since that's when you started measuring and hs-crp can be elevated for a number of reasons (cold, flu, infection, sleep, stress)? Maybe your baseline hs-crp is ~1mg/L.

Add: there is no doubt that fitness improves hs-crp. My hs-crp before the pandemic (when I was playing every day) - 1.4mg/L. After 2 years of inactivity: 5mg/L.


That's good to know about hsCRP. How much does your personal testing cost?

IIUC, they're not planning to provide a solution but rather a tool with a dashboard and some statistical insights. Even statistical insights could be problematic given how the FDA limited 23andme. Personally the FDA was overly eager, as the 23andme actually gave me some very helpful, if too late, knowledge on my genetic predisposition to an AI condition.

Well depending on how they execute it might be really helpful or not. The per test cost seems fairly high too.


It's super cheap for me, I live in India - roughly $6. But even in the US, it seems to be cheaper than with Be Golden.

Their value proposition seems to be the statistical insights - which they hope to have once enough people sign up (but that's also an untested claim really). Personally I think testing helps, at the very least you may get motivated enough to do something about it.


Just checked - in Slovenia a hsCRP is 8 eur (private testing, no healthcare participation): https://www.synlab.si/seznam-in-cenik-preiskav/crp-visoko-ob...


Why do you test for hsCRP and not CRP?

What exactly can I learn from my hsCRP values? What can I learn from hsCRP that I can't learn from CRP?

hsCRP is a very sensitive marker. If I'd exercise the day before the test and my values would be elevated? What would I learn from my result in this case?

Will your provide explanations of what influences my individual hsCRP levels and what specific interventions I should take in case they are elevated?

What is your process if you detect abnormally high hsCRP values? How do you alert your customers of their possibly lethal condition?

How does your service provide value to me as a customer apart from me not needing to go to a lab/doctor to get tested?

Anyways, I don't see much value in getting just hsCRP tested standalone without any other meaningful context. What about my iron levels? Vitamins? Lipid profile? IgG, IgA? HBa1c. On and on it goes. There is a reason that medical doctors collect a host of lab data to make informed decisions about their patients health and which possible interventions induce postive change without interdicting harmful side effects.


Apologies for the delay. There were a lot of questions so wanted to answer all of them in one shot.

>Why do you test for hsCRP and not CRP? What exactly can I learn from my hsCRP values? What can I learn from hsCRP that I can't learn from CRP?

hsCRP stands for high-sensitivity C-Reactive Protein, while CRP stands for C-Reactive Protein. Both tests measure the same protein, but hsCRP tests are more sensitive to lower inflammation levels and can therefore let you measure these lower levels.

See the 'Defining hs-CRP' section in this link for additional details: https://www.uspharmacist.com/article/the-application-of-high...

>hsCRP is a very sensitive marker. If I'd exercise the day before the test and my values would be elevated? What would I learn from my result in this case?

Experts recommend avoiding testing when you might be experiencing an acute (short term) elevation in hsCRP. Some instances that cause short term elevation include bacterial or viral infections and strenuous exercise (like running a marathon). These cause short term elevations in hsCRP because acute inflammation (short term spikes in inflammation) can help the body clear pathogens and heal tissues. Here is some related scientific literature you may enjoy: https://www.sciencedirect.com/science/article/pii/S073510970...

>Will your provide explanations of what influences my individual hsCRP levels and what specific interventions I should take in case they are elevated?

Yes, we focus on lifestyle interventions that help lower inflammation levels. You can find more info here: https://www.begolden.online/post/lifestyle-interventions-ass...

We plan to continue to build on this list

>What is your process if you detect abnormally high hsCRP values? How do you alert your customers of their possibly lethal condition?

The lab results should indicate if your levels are above normal. If you have any questions regarding your health, we encourage you to always seek the advice of your physician or another licensed health care provider

>How does your service provide value to me as a customer apart from me not needing to go to a lab/doctor to get tested?

We provide you the information to take action once you receive your lab results

>Anyways, I don't see much value in getting just hsCRP tested standalone without any other meaningful context. What about my iron levels? Vitamins? Lipid profile? IgG, IgA? HBa1c. On and on it goes. There is a reason that medical doctors collect a host of lab data to make informed decisions about their patients health and which possible interventions induce postive change without interdicting harmful side effects.

We plan to expand our list of biomarkers in the future, as we learn more about our customers


Really interesting chart on your lifestyle interventions link. Curcumin has both a very strong performance and pretty good range. Interesting to see that it is much more so than exercise or sleep improvements.


Relevant: “curcumin is a PAIN (pan-assay interference compound, ie a substance with weird chemical properties that make every test seem positive, so if you do chemical tests to see whether it activates eg coronavirus-fighting immune cells, it will always say yes). This means people are always publishing exciting papers about it and alternative medicine people are always getting really enthusiastic about it and suggesting it as the cure for everything (eg depression).”

From https://astralcodexten.substack.com/p/pascalian-medicine


Neat, TIL.


That error bar on magnesium though... they're quite certain it's either the single most effective treatment for inflammation, or totally useless.

https://static.wixstatic.com/media/26b4af_ab521cefbc2e46ba9b...


There will be a lot of iterations and improvements to your approach and the methodology.

Despite that, it is high time that low impact chronic conditions are treated in a personalized manner - by noting patient specific conditions and using the variations caused by lifestyle changes - for improvements.

Kudos to the team. Absolutely the step in the right direction


thank you!


This is a very appealing prospect and I'm sure you'll have no problem finding paying customers. The main question I can't help but ask is, how do I, or any potential customer for that matter, know that this isn't simply Theranos 2.0?


Great question! Theranos was designing its own testing machines. Be Golden is using existing validated testing methods.


Theranos promised to build a machine that would reduce the cost of blood samples by multiple order of magnitudes. They were unsuccessful in building it, and they lied about the progress of it all ton investors, journalists etc.

This is using existing - proven - testing methods and process. The claims are much less extraordinary; they are not claiming to completely transform an industry, but "merely" to give you additional insights on your health based on what's already known to be working.

Maybe it won't be successful or maybe the insights won't be as interesting as they claim, but it's nowhere near what Theranos was doing.


It's one conventional blood marker, widely used in medicine. Not suspicious IMO.


The chilling effect Theranos created was the worst outcome by far.

Most biomedicine companies aren't doing things which can lead to a Theranos result, and 99% of the companies which are building devices with an eye toward FDA approval are doing so honestly.


You can get a CRP level from any lab without a doctors order for about $30. The correct test, drawn and handled correctly, unlike this method.


Great point - our pricing is a function of the added costs of packaging, shipping, etc. We believe at home testing will offer consumers more convenience than going into the doctors office. However, if we learn that in person testing is preferred, we would definitely explore that as an offering!


It’s not hs-CRP like they’re using?


Not very practical to do every day.


Wanted to check - are you referring to the testing? If so, you are right! We actually recommend testing every 1-2 months to likely provide adequate time for change to your levels. Each person’s needs and time to impact will vary, so you can adjust this frequency up or down, depending on what works best for you.


I recently also developed an App to help me figure out my IBS and digestion problems. Basically i looked at all the apps in the app store but did not found a simple to use app. Inserting your meals should really be as simple as it possibly can, otherwise you will end up not using it at all.

If anyone is interested, it is currently available in the google app store. Apple coming soon. Foodolyst: https://play.google.com/store/apps/details?id=studio.creatne...

Also available as a webapp: https://app.foodolyst.creatness.studio

The app works in German&English. I haven't proof read every English entry however, so feedback is very much welcomed. I can return lifetime premium access in return :)

Okay enough advertising, sorry but the topic is quite interesting and everyone with food problems can just benefit from this.


Following up from my comment 2 days ago https://news.ycombinator.com/item?id=32656651

  > Some quick research shows these tests can be ordered by the patients, themselves, for ~$60, so the same as the disccounted/offer price here.

  > LabCorp: https://www.ondemand.labcorp.com/lab-tests/inflammation-hs-c...

  > Quest: https://questdirect.questdiagnostics.com/products/crp-inflam... 
I ordered the test the same day, got an appointment for blood draw the next day, and I have the results now, 2 days after this launch.

From the launch text:

> measuring your baseline inflammation levels using an at-home, finger prick based, blood testing kit, that includes a shipping label to send the sample back to the lab.

For my self-ordered test, the lab took a whole vial of blood, as opposed to Be Golden's finger-prick method. But I'm sure I got the results faster than I would have, if I had used the mail-in kit and waited for the results.

All in all, I think this a valuable test, and available at a reasonable cost.

Good luck to Be Golden. I hope they can bring the cost lower, and increase the speed and frequency of the test results.


Can I recommend an additional intervention to look into?

https://en.m.wikipedia.org/wiki/Diosmin — a chemical relative of hesperidin (a blood thinner like curcumin), but not itself a blood thinner — rather, diosmin affects lymphatic channel contractile tone in about the same way that hesperidin affects blood-vessel contractile tone. I.e. it makes your body better at pumping lymph.

Currently used by many for treatment of chronic veinous insufficiency (“spider veins”), as a side-effect of improved lymph flow is lower peripheral static pressure in cases of low veinous return rate. Also treats peripheral oedema, for similar reason. But that’s just a side-effect.

More interesting direct effect: it expedited wound healing (waste clearance from wound site), and decreases wound scarring. I.e. it makes your body do the thing it relies on your lymphatic system to do, faster and better. (Tattoos fade faster, even.)

Consequently, diosmin is the active ingredient of a an oral OTC anti-hemorrhoid drug. Because, by improving wound healing + lowering scarring enough, your body can clear wastes/senescent cells/etc faster than they can form into a hemorrhoid.

Obviously, a compound that can do this could be potentially of use in modulating all sorts of other inflammatory processes — but it’s critically under-researched, especially in chronic inflammation.


Useful service, and tried adding two tests, but decided to not order when I saw:

Recurring subtotal $268.00 every 12 months

Do not know if it is useful enough to renew, and I as a customer do not like services that presumptively charge me on and on and moves the onus to the customer to get out of the charging cycle.

Thanks, useful service, but not for me.


Good news - once you order, you will get an email that lets you manage your subscription at which point you can cancel the renewal right away. Let me know if you have any issues with that!


What would work better for me, as an individual, is to not lock me in, let me try the goods that I have paid for, and evaluate if it satisfies my need, and drive the value (through messaging) of leaving my credit card on your file for future charges.

That would still not be good news, but just a normal expected behavior from a lab testing service.

Again, I am cognizant of the business realities that makes you do this, and just reaffirming why I will not pay for your services.


Very understandable. We just created a new link where you can order without the subscription here: https://shop.begolden.online/products/2-tests

Hope you will give us a try!


Thank you and kudos for listening to your buyer(s).


I'm not sure how that is "good news". It's a nasty tactic, and shouldn't be celebrated.


If helpful, we just created a new link where you can order without the subscription here: https://shop.begolden.online/products/2-tests

Hope you will give us a try!


Hi Kimberly here - we greatly appreciate this feedback and we've now updated all of our offerings to have a one time purchase option: https://shop.begolden.online


Very interesting launch, congrats and good luck!

Anecdotally, I've struggled with inflammation (joint pain, needing lots of NSAIDs, adult-onset food allergies), but my C Reactive Protein levels were normal when tested.

Have you considered testing fo rother inflammatory markers that might help people like me?


Yes! Our plan is to expand into additional biomarkers in the future


Main advice from the blog is Curcumine, categorizing it as the most effective lifestyle change for bringing down inflammation. But, even though "natural", Curcumine is very strong and perhaps should be classified as a medicine.

This might seem like nitpicking. But something with a strong effect on the body hardly every just has the effect you want it to have. By seeing it as a medicine it forces you to also look at the negative side effects of it's use over a long period.

It's been known to help people with arthritis, but is it wise to use it on a daily basis as a healthy person?

Even things as basic as muscle growth have been known to be suppressed by anti-inflammatory medicines like Ibuprophen. I wouldn't be surprised if Curcumine does the same. As well as indications that it might block proper immune responses to infections at times, but Im not sure about this.

In general a lifestyle change in my opinion would be: sleep, exercise, stress, meditation, cutting out fried food etc.


Anecdotal warning about Curcumin (aka turmeric):

A good friend of mine is a cancer researcher who works in research as well as with clinicians at a famous institute. He told me about a case where one patient wasn’t responding to a novel and highly specific immunotherapy in a situation where they expected it to work well. They analyzed her cells and saw little activity fighting the cancer. It turns out she on her own was taking very high doses of Curcumin due to the generic advice that it’s good for you. It actually suppressed her immune system. Once she stopped she responded well to the treatment.

The lesson: taking supplements that you believe will have a meaningful impact on your body can do powerful things you don’t anticipate or appreciate the consequences thereof.


I think the bigger lesson is you let your physicians know what you're taking. Anytime I'm asked what I'm taking I include all the supplements I use and personally think you should be working with a doctor who is recommending the supplements.


BE GOLDEN DOES NOT PROVIDE MEDICAL SERVICES OR ADVICE. The information, including but not limited to text, graphics, images and other material contained on Be Golden's website and provided through Be Golden's services are for informational purposes only and do not contain or constitute, and should not be interpreted as, medical advice or opinion. No material on Be Golden's website or provided through Be Golden's services are a substitute for professional medical advice, diagnosis or treatment, and your use of Be Golden’s services does not create any provider-patient relationship. Always seek the advice of your physician or another licensed health care provider with any questions you may have regarding your health and before undertaking a new regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on Be Golden's website or through Be Golden's services. If you think you have a medical emergency, call 911.


These disclaimers are an easy way out.

Your product is clearly marketed & positioned as a health/medical product. With clear medical benefits for the use of your product. Even mentioning cancer and such.

As well as having clear recommendations in your blog what clients can do to bring their inflammation down.

It's then also your responsibility if these recommendations are effective and not harmful.

I understand it might be needed for legal, but then it also would be better to reframe your proposition.


To be honest, depends on what type of physician you are referring to. But when it comes to generalists, like many countries have as a first point of contact. Many of them try to keep up to date, but there is just too many diseases and research. At least where I'm from they mostly just dish out the general advice that's been created by a national organisation (and often they give the outdated version for a few years). With common ails they have more practical experience and are more useful. But regarding inflammation and it's longterm effects, I think this field is too new and specific. As been my personal experience many times, for instance with skin issues.



Cool! A couple suggestions:

1 - the CSS is all over the place on mobile, it looks pretty bad.

2 - maybe adjust the pricing of the bulk a bit. I assume you want to sell the bulk packs more, so incentivize them more.

Instead of $74 for 1 / $69 for 2, make it like $79 for 1 and $64 for 2, and make sure you say that’s “saving $30”. Right now it feels like it’s only $5 off which doesn’t convince me (yes I know it’s $10 actually).


Great feedback! Yes, our mobile experience (and frankly, web) definitely needs work!


Congrats on launching!

Compliments first - you described your elevator pitch of the company incredibly well in the starter post here on HN, to the point I'd use that as a template on your site and any kind of social media materials. Fantastic way to explain what the isasue is and how you're tackling it in a novel but practical way.

My immediate thought is "cool idea, but a non starter for me personally when I have a lot of questions about data and privacy" and how the team's handling patient's data. I'd highly encourage you to have a whole page at minimum elucidating the details there, if you're using E2E encryption, all that jazz. Given people's recent concerns about data collecting and menstrual cycles and the recent Roe fallout, this is of special concern to me as a woman.

Wishing you and the team best of luck, all the same!


Do you provide any context on the normally expected day-to-day variability in CRP levels? I imagine that getting spot checks once a month would require a few years (or perhaps decades) if data before signal could be reliability differentiated from noise in a given individual.

Have you established anything like this in pre-production testing? At least something as simple as "make no intentional changes to your lifestyle and test monthly for a year," and then institute your recommended lifestyle changes and test for another year? If so, it would be helpful data to make available (in a loud way -- I admit I read your post but haven't perused the website yet).

Are there interventions that lower CRP but have no effect (or negative effects) on health? I agree with other commenters regarding the problems of surrogate markers...


I'm sharing my personal results here, where you can see changes over time: https://www.begolden.online/post/our-ceo-s-hscrp-scores-over....


Thanks for sharing -- it's a little short on details though! Is there somewhere that you share what interventions you implemented when? And did you establish a baseline first?

I ask because if your initial level were omitted as a single outlier, the remainder of the chart would look a bit different.


Congratulations on your launch! We've had a lot of inquiries about inflammation when we see our patients at Wyndly (https://www.wyndly.com), so it's good to know someone is thinking about making this process easy!


thanks for the kind message!


Being a researcher in social sciences, one thing that puzzles me of medicine is that a single timepoint analysis leads to major decisions. I understand you perform analyses every 1-2 months, is there data indicating that the sweet spot for maximising information from testing is there?


The frequency of measurement is up to you. The more you test, the more detailed your data and insights are. Based on the data from clinical studies, some interventions can change inflammation levels (as measured by hsCRP) within weeks and others show within months. As such, we recommend testing every 1-2 months to likely provide adequate time for change to your levels. Each person’s needs and time to impact will vary, so adjust this frequency up or down, depending on what works best for you. See our blog to see how our CEO’s levels have changed over time: https://www.begolden.online/post/our-ceo-s-hscrp-scores-over...


This sounds like you're doing research. You're trying to gather data on daily habits and interventions taken by subjects and then looking at the impact on their blood marker levels. That is normally something that would happen in a randomized controlled trial or possibly epidemiological retrospective if you're doing pure data mining, and the research subjects would at worst be volunteers, but might even be paid. This feels like you're asking research subjects to pay to be research subjects so they can take your treatments that you don't yet have evidence for.

I don't mean to sound like I'm impugning your ethics, but why are you doing this as a startup and not a research proposal? Is it normal for YCombinator to fund medical research?


This is really cool, body inflammation plays a huge role in our lives.

3 years ago I had a terrible case of atopic urticaria that lasted 9 months. My CRP was over 10 mg/dL.

I started to make a handwritten habit diary to look for triggers. Food, type of exercises, exposure to temperatures, mood state, etc. Never pinpointed the issue, but I got better suddenly.

Went deep into the body inflammation rabbit hole and found interesting papers on how it relates with depression. I truly believe that my acquaintances suffering from depression could benefit from tracking their CRP levels on a consistent basis and try to bring it down.

Best of luck to the Be Golden team!


It’s great to see more companies focusing on inflammation. Is it possible to create a device like a continuous glucose monitor but for inflammation?


Th glucose monitor warns you to take Insulin but, The question for me is what action should be taken after high inflammation is detected? It seems like once an alert goes off, it's just a warning to go see a doctor.

The treatments for inflammation, and the indication of what specifically is causing it, seem to be rather limited to me beyond taking antibiotics or anti inflammatory meds.

Ibuprofen is fairly flawed as a regular treatment for many because of the ulcer risks...


There are many suggested treatments for inflammation, OP mentions “ginger”, my guess is that like everything else with the body certain treatments work for some people and not others. Like how CGM’s are used now not just for diabetes but for a tighter feedback loop on which foods, etc spike insulin, which allows a person to iterate their lifestyle faster. It’s the same with inflammation- If you have chronic inflammation and are trying to reduce it with diet, exercise, medication, naturopathic treatments, a tighter feedback loop would be a game changer, assuming it was possible. Perhaps CRP does not respond as quick to changes in the body as glucose, and measuring it all the time isn’t gaining much.


Great comment! We believe there is a future where continuous inflammation testing will be possible. Here's a team already working on building it: https://onlinelibrary.wiley.com/doi/pdf/10.1002/admt.2021013...

To your point, we see it as a potentially tighter feedback loop for seeing the impact of lifestyle changes.


Agreed, that only highlights the need to have a network of reliable places someone can go in order to have personally tailored care.

Just finding a doctor that can see you immediately in the US without racking up expensive emergency room fees is darn near impossible now in the US... It always comes back to our ritually broken health care system. :(


One interesting thing about going to continuous (or near-continuous) testing is you can get much narrower error bars on your baseline.

If you test once a month, how do you know if you accidentally tested during a transient spike?

If you test continuously, you can roll up those measurements to get things like p95, stddev, whatever.

So it’s useful even if you don’t want to respond in minutes to a spike. (You probably don’t need per-second readings for this, hourly would be enough.)

I don’t know if transient spikes are considered a risk factor, but you also get more chance to resolve those too.


Lifestyle changes including those related to nutrition, exercise, stress, and sleep can all improve inflammation levels. See our blog for a list of lifestyle interventions associated with decreased inflammation levels: https://www.begolden.online/post/lifestyle-interventions-ass...

Each person will respond differently so we suggest testing what works best for you.


We think so! We have started to see teams working on this and couldn't be more excited: https://onlinelibrary.wiley.com/doi/pdf/10.1002/admt.2021013...


This is very interesting. However, our lifestyle is not very linear, meaning that we can have some period more stressful than over. In this context, how do you deal with confounding variables ? For example, if my inflammation levels decrease in the next few weeks, it might be because I took some ginger everyday but it might also be because I had a less work and therefore more sleep.


Love this question. We can track as many additional variables as you like. For example - I track my lifestyle intervention (meditation) + 4 key dimensions of health (sleep, stress, nutrition, exercise) on a scale of 1-5 (1=bad, 5 = good). This gives me the added context you are talking about. In the future, we also plan to add the ability to connect to your wearables.


This is basically just facilitating people data dredging their own health. If you measure one outcome variable and enough "candidate" inputs you'll eventually find something that looks like a pattern.

As a doctor I measure CRP when I'm specifically looking for something - but that's in the context of having formed a differential diagnosis, then having considered the pre-test probably of each differential, and forming a view that the test result with alter the overall likely outcome. The last thing I would even want to do (for me or my patients) is to start randomly measuring CRP when generally well.

Why not just eat the ginger?


They don't even test for CRP but hsCRP (info is buried somewhere in the marketing babble). Also see my other comment below OP


I'm sitting in doctors office waiting for my appointment for an inflammation on my hand and I read this. What are the chances.


1


:)


Do they use their own lab tests or use a third party like Quest labs which also let you order your own tests.

https://questdirect.questdiagnostics.com/products/crp-inflam...


I've noticed that my C Reactive Protein were always high when I was taking creatine and doing strength training and wasn't sure which was the culprit. Likely both. Is there a way to account or correct for high hsCRP related to exercise or is the recommendation to do less intense exercise?


This hits perfectly on an FAQ we have:

Are there any times I should avoid testing?

Experts recommend avoiding testing when you might be experiencing an acute (short term) elevation in hsCRP. Some instances that cause short term elevation include bacterial or viral infections and strenuous exercise (like running a marathon). These cause short term elevations in hsCRP because acute inflammation (short term spikes in inflammation) can help the body clear pathogens and heal tissues.

Here is some related scientific literature you may enjoy: https://www.sciencedirect.com/science/article/pii/S073510970...


Congratulations on launching.

However as a potential customer interested in this space - I'm not sure the pricing/value prop is competitive for me. I used a service called InsideTracker (lab based blood test) earlier this year which measures 43 biomarkers (including hsCRP - my result was 0.4). I think I paid ~$500 for it but that gives a much more holistic view.

Is there a case for tracking hsCRP more frequently if my lifestyle is relatively healthy? Are there a few other biomarkers you could include for tracking more regularly with a finger prick? I could see at-home tests being more convenient.


Stupid question(s) for a non-medical person who doesn't even know enough to be wrong.

I really thought "inflammation" is/was a generic term for a myriad of different causes and symptoms. Did something change and now we "know" that inflammation == c reactive protein? Or is this just one particular well-known marker of a common cluster of inflammation symptoms? Or am I just completely confused about the whole thing?

happy to take answers from OP or others.


This is a great idea, but the website could be so much better. I felt like I wanted to be taken on a journey, of what is this? why does it matter to me? how does it work? how can I get involved? what's the projects future?

I love the idea, and so do many others, hence why Theranos was able to raise what it did, the idea of having insight into our own health is exciting, intriguing, and important.

I wish you the best of luck on your journey, but I would definitely improve on the site, if you have the resources to do so.


Did you actually read the copy on the website?

> Measure your baseline inflammation levels and see how they fluctuate with lifestyle choices (nutrition, exercise, sleep, stress) so that you can make the right choices for you

> Be Golden works by using an at home finger prick based blood testing kit and a digital platform

I'm not sure what "story" is left to be told here. It's pretty self-explanatory.


Just wondering why focussed on home-testing for 3-4x the price versus working with a central lab that is optimized for lowering their costs. Especially private lab chains might be interestes in additional business. The focus could be rather on results tracking & interpretation that could be done for example from remote doctors for more rural areas.

Source: Worked for a diagnostic company and later on added value service for personal healthcare records. Super interesting project you work on:).


Congrats on the launch! Coming from the longevity space, I am interested to know if your test is suitable to determine the efficacy of the following?

1. Meat vs Vegan Diet

2. Intermittent Fasting vs No Fasting


Thank you!!

Based on an initial scan of the publications below it seems like it would but I haven't had a chance to review the robustness of these publications yet so don't want to officially claim this yet :)

vegan diet: https://pubmed.ncbi.nlm.nih.gov/33303765/

intermittent fasting: https://www.sciencedirect.com/science/article/abs/pii/S08999...


I am a very inflammable (inflammed? not sure the terminology) person - allergic to pretty much everything, ezcema, IBS.

I've been to specialist doctors for all these things and they've mostly basically told me to go fuck myself ("You have IBS, can't help you there. Be grateful it's not cancer. Next patient!")

Anyways, the finger prick thing kind of intimidates me but I think this is exactly what I need!


Confused. Is it accurate that you are logging self-reported data daily, but only running diagnostic tests few times a year at roughly $100 a test depending on how many tests the end user commits to upfront? If so, with that combination of data, how is there any hope of meaningful analysis based individual specific observations?


I love all the new health monitoring startups.

I recently tried documenting my glucose using one of the many startups using electronic patches that measure glucose every few minutes.

What is the likelihood that a similar electronic patch would become available for inflammation in the industry?


We believe it will be possible to start doing a more "continuous" monitor for inflammation in the future and are looking forward to that day! If it is possible, we plan to offer it as part of Be Golden


Can you ship to and from Europe?


Not yet but we hope to expand globally in the future!


European here too and very interested in this too. Be worth you having a email signup form for notifications of rollout to other countries!


Good to know! As a short term hack - would you mind just noting you are from Europe in the "learn more" form under the open "other" field here: https://www.begolden.online/


I would but your site is jumping and scrolling back to the top whenever I try to fill the form in (on safari iOS)


Interesting approach, thanks for the good reads. Would love to support, no strings attached, if you see an opportunity. Reached out on LI, feel free to dump the request if this feels off to you.


I'll look out for the message!


The concept of quantifying inflammation is definitely interesting - best of luck and excited to see how this plays out!


Very interesting. I remember seeing data in the early days of Covid that CRP was quite correlated with severity


We are excited to potentially use our platform to research more in this area - for example, do people with higher baseline hsCRP levels have higher likelihood of long COVID?


Do you contract with a third party lab to analyze the samples? If so, can you share which one?


Yes. Email me at founders@begolden.io


Ug, why no shipping to New York?


Unfortunately, regulatory reasons but I believe we should be able to ship to NY by next year!


Congrats on the launch! Interested to know if my inflammation score will be a


I preordered test kits. Looking forward to using it soon and seeing my results!


thank you!


cool. I'm writing from another country. Is is possible to have an access to the tool, but doing the hscrp test from here?


I'd like to do some more research on this - for example, there may be some regulatory reasons we may not be able to. Can you email me at founders@begolden.io so I can follow up?


This would be great for canker sores.


.online is an interesting TLD choice.


Good luck Kimberly!


This gives me strong scam / nonsense vibes.



Thanks! Just fixed.


Nevermind it looks like ATT is just blocking it as spam. I can visit the website just fine from my t-mobile phone.


[flagged]


Actually the people with this sort of condition tend to have a sense for what foods may be causing them trouble. So they're already thinking "hmm...did I eat onion" earlier?? Automating this process they're already going through seems reasonable. Obviously this requires that the questions are tailored -- it wouldn't make sense to ask about a randomly selected food from the gamut of all foods.


Well it looks nice and shiny! But I'm afraid it's absolutely a revamp of uBiome. This sort of remote diagnosis simply can't be done to any degree of accuracy with a single pinprick blood sample. You need a significant program of investigation before you can start trying to isolate what you're looking for. Diagnosis of this type is incredibly complicated because there are so many variables - internal and external - involved.

And at those astronomical costs, the customer will go bust long before any meaningful results/benefits acrue. Not trying to be rude, but this is one of those projects which looks fantastic on a marketing slide deck, but in practice it's woefully inadequate. My only suggestion would be to pivot to a much more focused niche as soon as you can. One which can be reliable with minimal inputs.


> a revamp of uBiome.

That's simply untrue. You shouldn't make wild accusations that you can't back up. Almost everything about Be Golden and uBiome is different.

Be Golden is tracking biomarkers associated with inflammation. That is in itself is not a diagnosis. BG is gathering data that clinicians can use to make a diagnosis.

uBiome was using swabs, and BG is taking blood. And Be Golden's tech is not solely related to the microbiome, as uBiome was.





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