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Understanding Your Results

Screening results that fall OUTSIDE Campbell County Memorial Hospital's reference ranges (reported on the right side of the report form) will be marked with an L or H immediately behind the value. Values that are deemed "critical" values will be marked with L* or H* immediately behind the value.

Screening values that are outside the CCMH reference ranges:

  1. May show that you had eaten shortly before your blood was drawn.
  2. May mean there was a problem with drawing your blood.
  3. May indicate possible problems needing medical evaluation.

IT IS NOT POSSIBLE TO DIAGNOSE OR TREAT ANY DISEASE OR HEALTH PROBLEM WITH THIS BLOOD SCREEN ALONE. It can help you learn more about your body and detect potential problems in early stages when treatment or changes in personal health habits can be most effective.

You and your healthcare provider can learn a great deal about your health from a sample of your blood. Laboratory tests help in several ways. Sometimes test results will be abnormal before you have any symptoms. For those times when symptoms have developed, laboratory test results may help confirm that a problem does exist.

A normal test result is just as significant as an abnormal result. When a result is normal, it not only helps to rule out disease, but it also establishes a baseline for you. Each person has his or her own "normal" baseline. A person's own result is the best baseline for monitoring any change that takes place in the future. If any of your values are significantly different than previous results but still normal, contact your health care provider.

Medications and Fasting
Over-the-counter medications, prescription drugs, alternative medications, alcohol consumption and your fasting time may affect blood chemistry screening results. Your health care provider must have a complete and honest picture of your use of medications in order to effectively evaluate your health status. If all the needed information is provided, time and money will be saved. A 12-hour fast is recommended for the most accurate results.


Biometric Measurements

Biometric screenings are evaluations that look at your past, current, and potential future health conditions. This Biometric data that was collected at your wellness screening includes: blood pressure, oximetry, height, weight, body fat, and may also include a blood screen.

Heart Rate

A normal resting heart rate for adults ranges from 60-100 beats per minute. A lower heart rate at rest may indicate more efficient heart function and better cardiovascular fitness. If a resting heart rate is consistently above 100 beats per minute, follow up with a physician is recommended to determine a cause. Keep in mind that several factors can influence one’s heart rate including: activity level, fitness level, air temperature, body position (standing or lying), emotions, body size, and medications.

Oximetry

Oximetry is a basic measure of the blood’s oxygen carrying capacity. Optimal range is 93%-100%. Oximetry ranges below 93% may indicate hypoxia, a condition when the body is deprived of inadequate oxygen supply. This could indicate other medical conditions that should be followed up with a physician.

Blood Pressure

Blood pressure is the pressure exerted by the blood against the vessel walls. It varies based on many factors including: age, health, physical condition, elasticity of the vessel walls, the volume and viscosity of the blood, and the strength of the heart beat. It is important to remember that a single blood pressure reading is not diagnostic. If a blood pressure reading is high, recheck it and follow up with a physician it if remains elevated.

Optimal Prehypertension Hypertension
Systolic <120 120-139 140+
Diastolic <80 80-89 90+

Body Mass Index (BMI)

BMI is a measure for human body shape based off of an individual’s height and weight.

  • Underweight <18.5
  • Normal 18.5-24.9
  • Over Weight 25-29.9
  • Obese 30+

Body Fat

The body fat percentage is the total weight of fat divided by total body weight. This can then help determine ones lean body weight and fat body weight. Lean body weight is the mass of the non-fat parts of a body like muscle, organs, blood, and water. Fat body weight is the fat accumulation in tissues.

Age Male Female Classification
18-39 8-21% 21-33% Optimal
40-59 11-22% 23-35% Optimal
60+ 12-25% 22-36% Optimal

CBC – Complete Blood Count

The CBC is one of the most commonly ordered blood screening tests and is used to present a general picture of a person’s overall health. It also is used to help diagnose disease when people are “not feeling well” and to monitor treatment of many disease states, including anemia and leukemia. In the CBC test, the different types of cells in the blood are counted and examined by a machine. The seven components in a CBC are:

  • White Blood Cell Count (WBC)
  • Red Blood Cell Count (RBC)
  • Hemoglobin Concentration
  • Hematocrit Value
  • Indices
  • Platelet Count
  • White Blood Count Differential

White Blood Cell Count (WBC)
White blood cells are your body’s protectors. White blood cells are larger than red blood cells, but there are fewer of them.

  • Optimal Range: 3.7-10.7 K/mm3

When you have an infection, an increased number of white blood cells are sent form the bone marrow to attack the bacteria or virus that is causing the infection. An increased number of white blood cells may occur with mild infections, appendicitis, pregnancy, leukemia, hemorrhage, and hemolysis. Strenuous exercise, emotional distress, and anxiety can also cause an increase in WBC. A low white blood cell count makes it harder for your body to fight off an infection. People with a low WBC are more likely to catch colds or other infectious diseases. Low WBC counts may be seen in overwhelming infections like mumps, lupus, cirrhosis of the liver, and cancer. In addition, radiation therapy and certain types of drug therapy tend to lower the WBC.

Red Blood Cell Count (RBC)
Red blood cells are the most common type of cell in the blood. Your body contains millions upon millions of these disc-shaped cells. Red blood cells are continuously produced by the bone marrow in healthy adults. The cells contain hemoglobin, which carries oxygen and carbon dioxide throughout the body.

  • Optimal Range: 3.95- 5.35 M/mm3

The RBC determines if the number of red blood cells in your body is low (called anemia) or high (called polycythemia). Common causes of an abnormal RBC are iron deficiency anemia due to chronic blood loss (i.e.: menstruation, small amounts of bleeding due to colon cancer), acute blood loss (i.e.: acute bleeding ulcer, trauma), and hereditary disorders (i.e.: sickle cell anemia). Polycythemia is relatively uncommon.

Hemoglobin (HGB)
Red blood cells contain hemoglobin, the molecules that carry oxygen and carbon dioxide in the blood. Measuring hemoglobin gives an exact picture of the ability of the blood to carry oxygen. The oxygen is used by the cells to produce energy. The blood also brings carbon dioxide, the waste product of this energy production process, back to your lungs, where it is exhaled.

  • Optimal Range: 12.0-16.0 gm/dL

People with a low hemoglobin level most often have anemia and usually have a low red blood cell count and a low hematocrit. Signs of symptoms of anemia – paleness, shortness of breath, fatigue – will start to show when the hemoglobin is too low. Hemoglobin increases with altitude adaptation. In general, females have lower red blood cell counts and hemoglobin values than men.

Hematocrit (HCT)
The purpose of this test is to determine the ratio of plasma (clear liquid parts of the blood) to red cells in the blood or, in words; hematocrit measures how much of your blood is made of red cells.

  • Optimal Range: 36.0-48.0%

Hematocrit measurement is useful in indentifying anemia, and red cell production within the circulatory system. Hematocrit increases with altitude training or dehydration. Women generally have lower hematocrit values than men.

Indices
Indices are values which measure hemoglobin, hematocrit, and platelet components found in red blood cells. These indices include:

  • MCV: Mean cell volume, measures the average size of the red blood cells.
    • Optimal Range: 81.0-101.0 fl
  • MCH: Mean cell hemoglobin, reflects the average weight of hemoglobin found in the red blood cell.
    • Optimal Range: 27.9-33.3 PG
  • MCHC: Mean cell hemoglobin concentration, reflects the average amount of hemoglobin in the red blood cell.
    • Optimal Range: 31.9-35.9 g/dL
  • RDW: Red cell distribution width is a histogram (visual), which reflects the distribution of the size of the red blood cell population.
    • Optimal Range: 10.5-14.5%
  • MPV: Mean platelet volume, reflects the average volume of platelets.
    • Optimal Range: 5.7-11.7 fl

Platelets
Platelets are the smallest type of cell found in the blood. Platelets help stop bleeding after an injury by gathering around the injury site, plugging the hole in the bleeding vessel and helping the blood to clot more quickly.

  • Optimal Range: 140-410 K/mm3

Platelet counts are often done if you are prone to bruising or if you are about to have surgery. The platelet count may change with bleeding disorders, heart disease, diabetes, inflammatory disorders, and anemias.

Differential Blood Count
There are five different types of white cells that make up the differential blood count. White blood cells (leukocytes) come in several shapes and sizes and can be identified by the laboratory instrument known as a hematology analyzer, or under a microscope.

Neurtrophils: the most populous of the circulating white cells, they are also the shortest lived in circulation. After the production and release by the marrow, they only circulate for about eight hours before proceeding to the tissues, where they live for about a week.

  • Optimal Range: 41.4-74.4%

A high neutrophil count may be seen in infections, some cancers, arthritis, and sometimes when the body is under stress (for example after surgery, trauma, or a heart attack). A decreased neurtrophil may indicate liver damage, viral infections, lupus, drug reactions, anaphylactic shock, enlarged spleen, and damage to bone marrow.

Lymphocytes: function primarily to produce antibodies associated with immunity. They are the second most populous of the circulating white blood cells.

  • Optimal Range: 24.0-44.0%

An increased number of lymphocytes may be produced with a viral infection, bacterial infections, acute stress, chronic inflammatory disorders, and leukemia’s. A decreased number of lymphocytes may occur with chemo therapy and HIV.

Monocytes: monocytes and neutrophils share the same stem cell. They are produced by the marrow, circulate for five to eight days, and then enter the tissues where they are transformed into histocytes.

  • Optimal Range: 0.0-10.0%

High levels of monocytes may indicate chronic infections, infections within the heart, collagen vascular diseases (lupus, rheumatoid arthritis), and leukemia’s. Low levels of Monocytes may indicate bone marrow damage, or leukemia.

Eosinophils: these cells are traditionally grouped with the neutrophils and basophils.

  • Optimal Range: 0.0-4.7%

A high eosinophil count often indicates allergies, skin diseases, drug reactions, inflammatory disorder (celiac disease, inflammatory bowel disease), parasitic infections, and some cancers, lymphomas, and leukemia’s. Low levels of eosinophils are usually not medically significant. Low levels may indicate stress or acute inflammatory states.

Basophils: the basophils are the least numerous of the white cells. They are easily recognized by their very large deep purple granules.

  • Optimal Range: 0.0-1.6%

A high basophil may indicate rare allergic reactions, inflammation (rheumatoid arthritis, ulcerative colitis), and some leukemia’s. Low levels of basophils are usually not medically significant. Low levels may indicate stress or acute inflammatory states.

Diabetes Screen

Glucose

This test measures the amount of glucose in the blood or urine. Glucose is the primary energy source for the body’s cells and the only energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood.

  • Optimal Range: 70-100 mg/dL

Normally, blood glucose rises slightly after a meal and insulin is released by the pancreas into the blood in response, with the amount corresponding to the size and content of the meal. As glucose moves into the cells and is metabolized, the level in the blood drops and the pancreas responds by slowing, then stopping the release of insulin.

High levels also called hyperglycemia may present the following symptoms:

  • Increased thirst, usually with frequent urination
  • Fatigue
  • Blurred vision
  • Slow-healing infections

Low levels also called hypoglycemia may present the following symptoms:

  • Sweating
  • Hunger
  • Trembling
  • Anxiety
  • Confusion
  • Blurred Vision

Hemoglobin A1C

A1Cis a reflection of mean glucose levels for the previous 1-3 months.

HEMOGLOBIN A1C

APPROX/GLUCOSE mg/dl

INTERPRETATION: GLYCEMIA CONTROL

4-6

63-125

Non-diabetic or very good control

5-6

141

Upper limit of target for diabetes in control

6. 5-7

156

Marginal control: Take action above this level

>7

>156

Poor control: Take action to lower

Kidney Function

BUN

BUN (blood urea nitrogen) is a waste product from protein breakdown in the liver. It is excreted by the kidneys.

  • Optimal Range: 7-22 mg/dL

High levels may indicate:

· Dehydration

· Internal blood loss

· High protein diets

· Strenuous exercise

· Heart failure

Low levels may indicate:

  • Drinking too much water
  • Liver disease or damage
  • Poor Diet
  • Pregnancy

Creatinine

The main job of the kidney is to filter the blood, excreting waste products into the urine while preserving essential elements. One way to measure kidney function is to determine how well the kidney can filter and excrete creatinine, an easily measured waste product of muscle metabolism.

  • Optimal Range: 4.40-1.30 mg/dL

In certain types of kidney disease, the ability of the kidneys to clear the blood of creatinine decreases and blood levels of creatinine increase. High values require medical evaluation by your health care provider, especially when associated with high BUN results.

Some signs and symptoms of kidney dysfunction include:

  • Fatigue, lack of concentration, poor appetite, or trouble sleeping
  • Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs or ankles
  • Urine that is foamy, bloody, or coffee-colored
  • A decrease in the amount of urine
  • Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
  • Mid-back pain (flank), below the ribs, near where the kidneys are located
  • High blood pressure

High levels may indicate:

  • Damage to or swelling of blood vessels in the kidneys (glomerulonephritis) caused by, for example, infection or autoimmune diseases
  • Bacterial infection of the kidneys (pyelonephritis)
  • Death of cells in the kidneys' small tubes (acute tubular necrosis) caused by, for example, drugs or toxins
  • Prostate disease, kidney stone, or other causes of urinary tract obstruction
  • Reduced blood flow to the kidney due to shock, dehydration, congestive heart failure, atherosclerosis, or complications of diabetes

Electrolytes

Sodium

Sodium is one of the body's principal minerals, regulated by the kidneys. It plays an important role in water balance in your body.

  • Optimal Range: 135-146 mEq/L

High levels may indicate:

  • Excessive salt intake
  • Dehydration
  • Kidney Disease or injury
  • Diabetic Ketoacidosis
  • High levels of aldosterone by a high-sodium diet or by not drinking enough water and

Low levels may indicate:

Numerous drugs, including diuretics, certain blood pressure medications and steroids, may alter the sodium level. Any abnormal value should be evaluated by your healthcare provider.

Potassium

Potassiumis also one of the body's principal minerals, found primarily inside cells. It helps maintain water balance as well as proper function of nerves and muscles.

  • Optimal Range: 3.5-5.1 mEq/L

High Levels may indicate:

  • Kidney or liver disease
  • Too much medication
  • Bodily injury

Low Levels may indicate:

Chloride

Chlorideis also one of the body's minerals. Involved with water balance, most body chloride comes from salt in the diet.

  • Optimal Range: 98-108 mEq/L

High levels may indicate:

  • Severe dehydration
  • Hyperventilation
  • Kidney disease

Low levels may indicate:

  • Excessive vomiting
  • Diarrhea
  • Severe burns
  • Excessive sweating
  • Kidney failure

Gout

Uric Acid

Uric acid is a byproduct from the breakdown of the body's own cells and certain proteins.

  • Optimal Range: 3.5-7.2 mg/dL

High levels may indicate:

  • Gout
  • Arthritis
  • Kidney stones
  • Kidney disease
  • Stress
  • Alcohol
  • Diuretics

Low levels may indicate:

  • Severe liver disease, Wilson's disease, or some types of cancer.
  • Poor protein intake
  • Large doses of aspirin (1,500 mg or more daily)

Muscle and Bone Function

Magnesium

Magnesium helps regulate energy production in the cell. It is one of the most abundant minerals in the body.

  • Optimal Range: 1.7-2.4 mg/dL

High levels may indicate:

  • Kidney disease

Low levels may indicate:

  • Alcoholism
  • Severe malnutrition
  • Vomiting
  • Diarrhea

Calcium

Calcium is one of the most important elements in the body, essential for maintenance and repair of bone and teeth, heart function and blood clotting. Ninety-nine percent of the calcium in your body is contained in your bones - only one percent is in the blood.

  • Optimal Range: 8.6-10.3 mg/dL

High levels may indicate:

  • Bone disease
  • Excessive use of antacids and/or mild
  • Cancer
  • Overdosing on Vitamin D
  • Hormone disorders

Low levels may indicate:

  • Malnutrition

Phosphorus

Phosphorus is closely related to calcium in bone development. Most phosphorus in the body is found in bones.

  • Optimal Range: 2.3-4.3 mg/dL

High levels may indicate:

  • Kidney disease

Low levels may indicate:

  • Starvation or malnutrition
  • Muscle weakness

Iron

Iron

The body must have iron to make hemoglobin and to help transfer oxygen to the muscles.

  • Optimal Range: 49-151 ug/dL

High levels may indicate:

  • Cirrhosis of the liver
  • Lead Poisoning
  • Rheumatoid arthritis
  • Kidney failure
  • Overuse of iron supplements

Too much iron in the body can cause injury to the heart, pancreas, joints, testicles, ovaries, etc. Iron excess is found in the hereditary disease called hemochromatosis which occurs in about 3 out of every 1000 people.

Low levels may indicate:

  • Anemia
  • Bleeding
  • Severe infection

If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function as well as they should.

Total Iron Binding Capacity (TIBC)

lron is transported in your blood bound to a protein called transferrin. Transferrin transports the iron in your body from the iron storage sites to where it is needed. It also transports the iron, when not needed, back to the storage sites.

  • Optimal Range: 260-400 ug/dL

High levels may indicate:

  • Iron deficiency

Low levels may indicate:

  • Malnutrition
  • Iron excess

Iron Saturation Index

Iron saturation index is obtained by comparing the iron level to the TIBC level. It is a simple way to compare the amount of iron in the blood to the capacity of the blood to transport iron.

  • Optimal Range: 15-50%

With iron deficiency anemia you will typically see Low iron and low saturation index with a TIBC.

Ferritin

Ferritinis measured if the iron saturation index is low or high. Ferritin is the chief storage form of iron in the body.

  • Optimal Range: 30-400 ng/ml

High levels may indicate:

  • Iron excess
  • Inflammation
  • Liver disease

Low levels may indicate:

  • Iron deficiency

Liver Function

Albumin

Albumin is the most plentiful protein in the blood. Approximately two-thirds of the total protein circulating in your blood is albumin. It is produced primarily in the liver and helps keep the fluid portion of the blood within the blood vessels.

  • Optimal Range: 3.4-5.0 gm/dL

High levels may indicate:

  • Severe dehydration

Low levels may indicate:

  • Too much water in the body
  • Malnutrition
  • Liver disease
  • Kidney disease
  • Severe injury or major bone fractures
  • Slow bleeding over long period of time

Globulins

Globulins are proteins that can be formed in the liver or the immune system. Globulins have many functions, transporting a variety of things such as fats and hormones and acting as infection fighters to help the body defend itself. If your globulin level is abnormal your health care provider may want to measure some of the individual proteins that make up this group.

High levels may indicate:

Total Protein

Total protein is a measure of the total amount of protein in your blood.

  • Optimal Range: 6.4-8.2 gm/dL

A low or high protein does not indicate a specific disease, but it does mean that some additional tests may be required to determine if there is a problem.

ALB/Globulin Ratio

A simple way to tell if the albumin or globulin levels in the blood are abnormal is to compare the level of albumin to the level of globulin in your blood. If both the albumin and globulin results fall within the specified reference range, then a high or low AIG Ratio result is not generally considered significant.

Total Bilirubin

Total bilirubin is the pigment in the blood that makes the plasma or serum part of your blood yellow.

  • Optimal Range: 0.0-1.0 mg/dL

When the bilirubin level in the blood is very high for a period of time, the whites of your eyes and your skin may become yellow - this is known as jaundice. Bilirubin comes from the breakdown of old red cells in the blood.

A high bilirubin level in the blood can be caused by red blood cells being destroyed (hemolyzed), by liver disease, or by a blockage of bile ducts.

High levels may indicate:

  • Red blood cells being destroyed (hemolyzed)
  • Liver disease
  • Blockage of bile ducts

Direct Bilirubin

Direct bilirubin is a specific form of bilirubin that is formed in the liver and excreted in the bile.

  • Optimal Range: 0.0-0.3 mg/dL

Normally very little of this form of bilirubin is found in the blood. However, in liver disease, this form of bilirubin leaks into the blood so a high level of direct bilirubin may indicate a problem with the liver cells.

High levels may indicate:

  • Infection
  • Inherited diseases, such as Gilbert's syndrome, a condition that affects how the liver processes bilirubin. Although jaundice may occur in some people with Gilbert's syndrome, the condition is not harmful.
  • Diseases that cause liver damage, such as hepatitis, cirrhosis, or mononucleosis.
  • Diseases that cause blockage of the bile ducts, such as gallstones or cancer of the pancreas.
  • Rapid destruction of red blood cells in the blood, such as from sickle cell disease or an allergic reaction to blood received during a transfusion (called a transfusion reaction).
  • Reaction to medication

Low values may indicate:

  • Reactions to medication

Alkaline Phosphatase

Alkaline phosphatase is an enzyme that is found in many body tissues, but the most important sites are bone, liver, bile ducts and gut.

  • Optimal Range: 32-122 U/L .

High levels may indicate:

  • Bone disease
  • Liver disease
  • Bile duct disease
  • Certain drugs

Low levels may indicate:

  • Conditions that lead to malnutrition (such as celiac disease) or are caused by a lack of nutrients in the diet (such as scurvy)

Liver & Kidney Function

Gamma-Glutamyltransferase (GGTP)

Gamma Glutamyltransferase is an enzyme' that is primarily found in the liver. Drinking too much alcohol, certain drugs, liver disease, stress, physical exertion, some common medications and bile duct disease can cause high levels of GGTP in the blood.

  • Optimal Range: 7-32 U/L

High levels may indicate:

Transaminase, AST (SGOT)

The AST enzyme1 is found mainly in the heart, liver, pancreas, kidney’s, and muscles. It is released into the blood stream when any of these organs are damaged.

  • Optimal Range: 9-45 U/L

Very High levels may indicate:

Slightly high levels of AST may indicate:

  • Fatty deposits in the liver
  • Alcohol abuse
  • An overdose of acetaminophen (Tylenol). People who drink alcohol and take a lot of acetaminophen (such as Tylenol) can also have high AST blood levels.
  • Reaction to medication

Transaminase, ALT (SGPT)

The ALT enzyme1 is found mainly in the liver.

  • Optimal Range: 7-63 U/L

Damage from alcohol, strenuous exercise and a number of diseases can cause high values for both AST (SGOT) and ALT (SGPT) and should be evaluated by your health care provider. Low values are not generally considered significant.

Very high levels of ALT may indicate:

  • Recent or severe liver damage
  • Lead poisoning
  • Drug reactions
  • Exposure to carbon tetrachloride
  • Decay of a large tumor (necrosis)
  • Shock

Mildly or moderately high ALT levels may indicate:

  • Mononucleosis
  • Hepatitis
  • Alcohol abuse
  • An overdose of acetaminophen (Tylenol). People who drink alcohol and take a lot of acetaminophen (such as Tylenol) can also have high ALT blood levels.
  • Growth spurts, especially in young children. Rapid growth can cause mildly elevated levels of ALT.

Slightly high ALT levels may indicate:

  • Fatty deposits in the liver
  • Reaction to medication
  • Long-term (chronic) diseases that affect the liver, such as cirrhosis

Heart Function

Cholesterol

Cholesterolis an essential blood fat found in nearly every body tissue.

  • Optimal Range: 120-200 mg/dL

Elevated levels have been shown to be associated with a higher risk of heart disease and clogged blood vessels.

HDL Cholesterol

High density lipoprotein (HDL) cholesterol is part of the "total cholesterol." It is referred to as "good cholesterol" because it acts as a scavenger, removing excess cholesterol from artery walls.

  • Optimal Range: 40-96 mg/dL

It has been shown that the HIGHER the level of HDL cholesterol the LOWER the risk of developing heart disease.

Recommendations:

  • Smoking Cessation
  • Weight loss
  • Regular activity
  • Decrease simple sugar intake
  • Increase Omega-3 Fatty Acids with fish and nuts (walnuts, pistachios, almonds) to decrease inflammation.
  • Moderate alcohol intake

LDL Cholesterol

Low density lipoprotein (LDL) cholesterol is a part of the "total cholesterol." This is the cholesterol that forms deposits on artery walls.

  • Optimal Range: 53-130mg/dL

The LOWER the amount of LDL cholesterol, the LOWER the risk of developing heart disease.

Recommendations:

  • Increase antioxidant intake with more fruits and vegetables to decrease oxidation of LDL Cholesterol and reduce plaque formation.
  • Increase fiber intake with whole grain breads, cereals, pastas as well as fruits and vegetables. Fiber binds to LDL cholesterol and takes it to the liver for excretion.
  • Increase Omega-3 Fatty Acids with fish and nuts (walnuts, pistachios, almonds) to decrease inflammation
  • Limit saturated fat intake from high fat meats and dairy as well as fast food and fried food.
  • Avoid trans fatty acids from processed foods.

Cholesterol/HDL Ratio

This ratio is obtained by comparing the total cholesterol level to the HDL cholesterol level.

  • 3.0 or below = low risk
  • 3.1-4.4 = average risk
  • 4.5-5.0 = increased risk
  • 5.1-6.4 = high risk
  • 6.5 or higher = extreme risk

The higher this number, the greater the risk of coronary heart disease. A high HDL cholesterol level will result in a lower ratio, which means a lower risk. This could be true even if the total cholesterol level is high. It is this ratio that appears to best measure the lipid associated risk of your developing coronary heart disease.

Triglycerides

Triglyceridesare a fatty substance in the body which acts as a major form of stored energy. This is a blood fat that may be related to a higher risk of heart disease.

  • Optimal Range: 30-150 mg/dL

Elevated levels may be caused by food and alcohol. It is recommended that you not eat for at least 12 hours to obtain an accurate result for this test. Low values are not generally considered significant.

Recommendations:

  • Smoking Cessation
  • Weight loss
  • Regular activity
  • Decrease simple sugar intake
  • Increase Omega-3 Fatty Acids with fish and nuts (walnuts, pistachios, almonds) to decrease inflammation.
  • Moderate alcohol intake

hsCRP (Highly Sensitive C-Reactive Protein)

Studies have shown that the combination of Cardio hsCRP with the Cholesterol: HDL-Cholesterol ratio is the strongest independent predictor of peripheral artery disease.

Cardio CRP may also help identify patients at risk of first MI even with low-to-moderate risk lipid levels.

Thyroid Function

TSH (Thyroid Stimulating Hormone)

TSH is the pituitary hormone which controls thyroid gland function. It stimulates the thyroid to produce thyroid hormone.

  • Optimal Range: 0.27-5.76uIU/m (per CCMH Lab ranges)

When the thyroid gland fails, due to primary disease of the thyroid, pituitary TSH increases. This condition is called primary hypothyroidism. In contrast, when the thyroid gland is overactive and producing too much thyroid hormone, the serum TSH decreases. This is called primary hyperthyroidism. Both primary hypothyroidism and hyperthyroidism can be detected by the sensitive TSH method. In addition, the TSH test can tell if your dose of thyroid hormone is correct, should you be taking that medication.

High levels may indicate:

  • Congenital hypothyroidism (cretinism)
  • Exposure to mice (lab workers or veterinarians)
  • Primary hypothyroidism
  • Thyroid hormone resistance
  • TSH-dependent hyperthyroidism

Low levels may indicate:

  • Hyperthyroidism
  • TSH deficiency
  • Reaction to medication

T3

This test measures the amount of triiodothyronine, or T3, in the blood. T3 is one of two major hormones produced by the thyroid gland. It is ordered primarily to help diagnose hyperthyroidism and may be ordered to help monitor the status of a person with a known thyroid disorder.

T3 testing may be ordered along with thyroid antibodies to help diagnose Graves disease, an autoimmune disorder that is the most common cause of hyperthyroidism.

T4

T4 test is primarily ordered in response to an abnormal TSH test result. This test is usually ordered when a person has symptoms of hyperthyroidism or hypothyroidism.

TSH

T4

T3

Interpretation

High

Normal

Normal

Mild (subclinical) hypothyroidism

High

Low

Low or normal

Hypothyroidism

Low

Normal

Normal

Mild (subclinical) hyperthyroidism

Low

High or normal

High or normal

Hyperthyroidism

Low

Low or normal

Low or normal

Non-thyroidal illness; rare pituitary (secondary) hypothyroidism

Prostate (Males)

Prostatic Specific Antigen (PSA)

PSAis a blood test that measures a protein that is only produced by the male prostate gland. Elevations of PSA may occur in men with prostate cancer or non-cancerous prostatic diseases.

  • Optimal Range: 0.0-4.0 ng/mL

A normal PSA level does not entirely exclude the possibility of prostate cancer. Although high PSA values do not always indicate prostate cancer.

Vitamins

Vitamin D

Vitamin D is a fat soluble vitamin that helps control calcium and phosphate levels in the body, critical for growth and teeth.

The main role of vitamin D is to help regulate blood levels of calcium, phosphorus, and (to a lesser extent) magnesium. Vitamin D is vital for the growth and health of bone; without it, bones will be soft, malformed, and unable to repair themselves normally, resulting in diseases called rickets in children and osteomalacia in adults. Vitamin D has also been shown to influence the growth and differentiation of many other tissues and to help regulate the immune system. These other functions have implicated vitamin D in other disorders, such as autoimmunity and cancer.

A vitamin D test is used to:

  • Determine if bone weakness, bone malformation, or abnormal metabolism of calcium (reflected by abnormal calcium, phosphorus, PTH) is occurring as a result of a deficiency or excess of vitamin D
  • Help diagnose or monitor problems with parathyroid gland functioning since PTH is essential for vitamin D activation
  • Screen people who are at high risk of deficiency, as recommended by the National Osteoporosis Foundation, the Institute of Medicine, and the Endocrine Society
  • Help monitor the health status of individuals with diseases that interfere with fat absorption, such as cystic fibrosis and Crohn disease, since vitamin D is a fat-soluble vitamin and is absorbed from the intestine like a fat
  • Monitor people who have had gastric bypass surgery and may not be able to absorb enough vitamin D
  • Help determine the effectiveness of treatment when vitamin D, calcium, phosphorus, and/or magnesium supplementation is prescribed

A low blood level of 25-hydroxyvitamin D may mean that a person is not getting enough exposure to sunlight or enough dietary vitamin D to meet his or her body's demand or that there is a problem with its absorption from the intestines. Occasionally, drugs used to treat seizures, particularly phenytoin (Dilantin), can interfere with the production of 25-hydroxyvitamin D in the liver.

There is some evidence that vitamin D deficiency may increase the risk of some cancers, immune diseases, and cardiovascular disease.

A high level of 25-hydroxyvitamin D usually reflects excess supplementation from vitamin pills or other nutritional supplements.

Vitamin B12 & Folate

Vitamin B12 and folate are both part of the B complex of vitamins. These tests measure the levels of folate and vitamin B12 in the liquid portion of the blood, the serum or plasma, to detect deficiencies.

Some causes of low B12 or folate include:

  • Insufficient intake—Dietary deficiency of folate or B12 is uncommon in the U.S. It sometimes may be seen with general malnutrition and in vegans who do not consume any animal products, including milk and eggs. With the introduction of fortified cereals, breads, and other grain products, folate deficiency is very rare.
  • Malabsorption—Both B12 and folate deficiencies may be seen with conditions that interfere with their absorption in the small intestine. These may include:
    • Celiac disease and tropical sprue
    • Bacterial overgrowth or the presence of parasites in the intestines
    • Reduced stomach acid production from long-term use of antacids or H2 proton pump inhibitors
    • Pernicious anemia, the most common cause of B12 deficiency
    • Surgery that removes part of the stomach, such as gastric bypass, or the intestines may greatly decrease absorption.
    • Pancreatic insufficiency
  • Chronic alcoholism can cause B12 and/or folate deficiency due to poor intake and impaired release of B12 from dietary proteins.
  • Some drugs can cause B12 deficiency, such as metformin and omeprazole, which cause B12 malabsorption and impaired release of B12 from food proteins due to decrease in gastric acids, respectively.
  • Anti-seizure medications such as phenytoin can decrease folate as can drugs such as methotrexate, which blocks folate absorption and affect body metabolism and utilization of folate, respectively.
  • Increased need--All pregnant women need increased amounts of folate for proper fetal development. People with cancer that has spread (metastasized) or with chronic hemolytic anemia have increased need for folate.

If a person with a B12 or folate deficiency is being treated with supplements (or with B12 injections), then normal or elevated results indicate a response to treatment.

High levels of B12 are uncommon and not usually clinically monitored. However, if someone has a condition such as chronic myeloproliferative disorder, diabetes, heart failure, obesity, AIDS, or severe liver disease, then they may have an increased vitamin B12 level.

HIV

Human immunodeficiency virus (HIV) is the cause of AIDS (acquired immunodeficiency syndrome). This test detects antibodies produced in response to an HIV infection.

An HIV infection may initially cause no symptoms or cause flu-like symptoms that resolve after a week or two. This is followed by a simmering infection that may cause few symptoms for a decade or more. If the infection is not treated, eventually symptoms of AIDS emerge and begin to progressively worsen. Over time, HIV destroys the immune system and leaves a person's body vulnerable to debilitating infections.

However, a negative screening test means only that there is no evidence of disease at the time of the test. It is important for those who are at increased risk of HIV infection to have screening tests performed on a yearly basis to check for possible exposure to the virus.

If someone tests positive for HIV on both the initial screen and supplemental testing, he is considered to be infected with HIV. HIV cannot be cured, but early diagnosis allows for treatment that can help to suppress levels of virus in the body (viral load) and slow progression of the disease.

Blood Typing

Blood Typing

Blood typing is used to determine an individual's blood group and what type of blood or blood components the person can safely receive. It is important to ensure that there is compatibility between a person who requires a transfusion of blood or blood components and the ABO and Rh type of the unit of blood that will be transfused. A potentially fatal transfusion reaction can occur if a unit of blood containing an ABO antigen to which a person has an antibody is transfused to that person.

Red blood cells (RBCs) have markers or antigens on the surface of the cells. Two major antigens or surface identifiers on human RBCs are the A and B antigens. Blood is grouped according to the presence or absence of these antigens. People whose red blood cells have A antigens are considered to be blood group A; those with B antigens are group B; those with both A and B antigens are group AB; and those who do not have either of these markers are considered to have blood group O. Another important surface antigen is called Rh factor. If it is present on the red blood cells, a person's blood type is Rh+ (positive); if it is absent, the person's blood is type Rh- (negative).

Our bodies naturally produce antibodies against the A and B antigens we do not have on our red blood cells. For example, a person who is blood type A will have antibodies directed against the B antigens on red blood cells and someone who is type B will have anti-A antibodies and so on.

The following table indicates the type of antibodies a person is expected to have based on their blood type.

a person with bloodtype ...

will have antibodies to ...

A

B antigen

B

A antigen

AB

Neither antigen

O

A and B antigens

The results of blood typing will determine if a person is group A, B, AB, or O and if he or she is Rh negative or positive depending on what antigens are present on the person's red blood cells. The results will tell the physician what blood or blood components will be safe for the person to receive.

Blood group and Rh type

Can safely receive blood that is...

A positive

A positive, A negative, O positive, O negative

A negative

A negative, O negative

B positive

B positive, B negative, O positive, O negative

B negative

B negative, O negative

AB positive

AB positive, AB negative, A positive, A negative, B positive, B negative, O positive, O negative

AB negative

AB negative, A negative, B negative, O negative

O positive

O positive, O negative

O negative

O negative

The results will tell a pregnant woman whether she is Rh positive or negative and whether she may be a candidate for receiving Rh immune globulin to prevent her from potentially developing antibodies against her fetus' blood cells.

Hormones

Estadiol

Estradiol levels are used in evaluating ovarian function.

Increased levels of estrogens are seen in:

Decreased levels of estrogen are seen in:

FSH (Follicle Stimulating Hormone)

FSH is often used in conjunction with other tests (LH, testosterone, estradiol, and progesterone) in the workup of infertility in both men and women. FSH levels are used to help determine the reason a man has a low sperm count. FSH levels are also useful in the investigation of menstrual irregularities and to aid in the diagnosis of pituitary disorders or diseases involving the ovaries or testes. In children, FSH and LH are used to diagnose delayed or precocious (early) puberty.

In women, FSH and LH levels can help to differentiate between primary ovarian failure (failure of the ovaries themselves) and secondary ovarian failure (failure of the ovaries due to disorders of either the pituitary or the hypothalamus). Increased levels of FSH and LH are consistent with primary ovarian failure. Some causes of primary ovarian failure are listed below.

Developmental defects:

  • Failure to develop ovaries (ovarian agenesis)
  • Chromosomal abnormality, such as Turner's syndrome
  • Defect in the steroid production by the ovaries, such as 17 alpha hydroxylase deficiency

Premature ovarian failure due to:

Chronic failure to ovulate (anovulation) due to:

When a woman enters menopause and her ovaries stop working, FSH levels will rise.

Low levels of FSH and LH are consistent with secondary ovarian failure due to a pituitary or hypothalamic problem. Low FSH serum levels have been associated with increased risk of ovarian cancer.

In men, high FSH levels are due to primary testicular failure. This can be due to developmental defects in testicular growth or to testicular injury, as indicated below.

Developmental defects:

  • Failure to develop gonads (gonadal agenesis)
  • Chromosomal abnormality, such as Klinefelters syndrome

Testicular failure:

  • Viral infection (mumps)
  • Trauma
  • Radiation
  • Chemotherapy
  • Autoimmune disease
  • Germ cell tumor

Low levels are consistent with pituitary or hypothalamic disorders.

High levels of FSH and LH with the development of secondary sexual characteristics at an unusually young age are an indication of precocious puberty. This is much more common in girls than in boys. This premature development can have many different underlying causes that need to be diagnosed and treated. Some of the causes include:

  • Central nervous system lesions
  • Hormone-secreting tumors
  • Ovarian tumors or cysts
  • Testicular tumors

Normal prepubescent levels of LH and FSH in children exhibiting some signs of pubertal changes may indicate a benign form of precocious puberty with no underlying or discernable cause or may just be a normal variation of puberty.

In delayed puberty, LH and FSH levels can be normal or below what is expected for a youth within this age range. A test for LH response to GnRH may need to be performed along with other testing to diagnose the reason for the delayed puberty. Some of the causes for delayed puberty can include:

  • Gonadal (ovary or testes) failure
  • Hormone deficiency
  • Turner's syndrome (chromosomal abnormality in girls)
  • Klinefelter's syndrome (chromosomal abnormality in boys)
  • Chronic infections
  • Cancer
  • Eating disorder (anorexia nervosa)

Progesterone

Progesterone isused to determine the cause of infertility, track ovulation, help diagnose an ectopic or failing pregnancy, monitor the health of a pregnancy, and help diagnose the cause of abnormal uterine bleeding.

This test measures the level of progesterone in the blood. Progesterone is a steroid hormone whose main role is to help prepare a woman's body for pregnancy; it works in conjunction with several other female hormones.

Increased progesterone levels also are seen occasionally with:

  • Some ovarian cysts
  • Non-viable pregnancies known as molar pregnancies
  • A rare form of ovarian cancer
  • Overproduction of progesterone by the adrenal glands
  • Congenital adrenal hyperplasia (CAH)

Low levels of progesterone may be associated with:

  • Toxemia late in pregnancy
  • Decreased function of ovaries
  • Lack of menstruation (amenorrhea)

Testosterone

Testosterone is a steroid hormone (androgen) produced by special endocrine tissue (the Leydig cells) in the male testicles. It is also produced by the adrenal glands in both males and females and, in small amounts, by the ovaries in females. This test measures the level of testosterone in the blood.

Testosterone testing is used to diagnose several conditions in men, women, girls, and boys. Examples of some of these conditions include:

Males:
The normal range for testosterone levels in men is broad and varies by stage of maturity and age. It is normal for testosterone levels to slowly decline starting in the third decade of life. The rate may increase in men who are obese or chronically ill and with the use of certain medications.

A low testosterone level (hypogonadism) may be due to:

  • Hypothalamic or pituitary disease
  • Genetic diseases that can cause decreased testosterone production in young men (Klinefelter, Kallman, and Prader-Willi syndromes) or testicular failure and infertility (as in myotonic dystrophy, a form of muscular dystrophy)
  • Impaired testosterone production because of acquired damage to the testes, such as from alcoholism, physical injury, or viral diseases like mumps

Increased testosterone levels in males can indicate:

  • Testicular tumors
  • Adrenal tumors that are producing testosterone
  • Use of androgens (also called anabolic steroids)
  • Early puberty of unknown cause in boys
  • Hyperthyroidism
  • Congenital adrenal hyperplasia

Females:
In women, testosterone levels are normally low. Increased testosterone levels can indicate:

  • PCOS
  • Ovarian or adrenal gland tumor
  • Congenital adrenocortical hyperplasia

References:

Lab Tests Online

Medline Plus

Mayo Clinic

National Institutes of Health

WebMD

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