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:
- May show that you had eaten shortly before your blood was drawn.
- May mean there was a problem with drawing your blood.
- 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 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.
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 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 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.
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+
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.
GLUCOSE is the primary energy source for all body tissues. The sugars and carbohydrates you eat are ordinarily converted into glucose, which can be used to either produce immediate energy or be stored in the liver or as fat throughout the body. High blood glucose (hyperglycemia) after fasting for I2 hours suggests diabetes. Your doctor may want to do further testing.
A low glucose level (hypoglycemia) accompanied with symptoms such as weakness, nausea, sweating and difficulty thinking clearly, is suggestive for hypoglycemia.
Even if you know you have diabetes, it is important to report any abnormal levels to your health care provider.
HEMOGLOBIN A1C is a reflection of mean glucose levels for the previous 1-3 months.
||INTERPRETATION: GLYCEMIA CONTROL
||Non-diabetic or very good control
||Upper limit of target for diabetes in control
||Marginal control. Take action above this level
||Poor control: Take action to lower
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
If kidney function is impaired, or if a person is dehydrated, the BUN level will increase. Internal blood loss, high protein diets and/or strenuous exercise can also cause a high BUN level. A low BUN level may be the result of liver disease, poor diet, pregnancy or drinking too much water.
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.
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
A high level can be caused by dehydration, excessive salt intake in your diet or certain diseases. A low level of sodium may be caused by diarrhea, vomiting, or excessive sweating. 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 is 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
Low or high levels in the blood are of critical significance and should be evaluated by your health care provider. This is especially important if you are taking a diuretic or heart medication. A high level may indicate kidney or liver disease, too much medication or bodily injury, such as a burn. A low level of potassium can develop rapidly, most frequently produced as a side effect of drugs that cause increased urination.
CHLORIDE is 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
A high chloride level may mean severe dehydration, certain kidney disorders or hyperventilation. A low chloride level may result from excessive vomiting, diarrhea, severe burns, excessive sweating or kidney failure. Borderline low or high levels of chloride have very little significance.
Muscle and Bone Function
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
A low magnesium level in the blood may indicate alcoholism, severe malnutrition, vomiting or diarrhea. High values indicate kidney disease. As with all other abnormal results, any value outside the reference range should be reported to your health care provider.
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
Low levels of calcium in the blood are associated with malnutrition. High levels can be caused by bone disease, excessive use of antacids and milk, cancer, overdosing on Vitamin D and some hormone disorders. Any elevated calcium level should be elevated by your health care provider.
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
Very low levels of phosphorus can be associated with starvation or malnutrition, leading to muscle weakness. High levels of phosphorus are associated with kidney disease. Values outside the specified reference range should be reported to your health care provider.
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
A high level of uric acid in blood may cause gout, arthritis or kidney stones.Kidney disease, stress, alcohol and certain diuretics may also raise the level. High levels should be evaluated by your health care provider, whereas low values are not generally considered significant.
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
When your albumin level is too low, water can leak into other parts of your body and cause swelling. This can be caused by malnutrition, too much water in the body, liver or kidney disease, severe injury or major bone fractures and slow bleeding over a long period of time.
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.
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/GLOBULlN 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 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.
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.
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
A high level of alkaline phosphatase in your blood may indicate bone, liver, or bile duct disease. Certain drugs may also cause increased levels. Growing children, because of bone growth, normally have higher levels than adults. Low values are not generally considered significant.
IRON The body must have iron to make hemoglobin and to help transfer oxygen to the muscles.
- Optimal Range: 49-151 ug/dL
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. On the other hand 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. Any value outside the specified reference range should be evaluated by your health care provider.
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
A lower IBC suggests malnutrition or iron excess. A high IBC suggests iron deficiency.
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.
FERRlTlN is 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
The level is low in iron deficiency and is high in iron excess, inflammation, and liver disease.
Liver & Kidney Function
GAMMA-GLUTAMYLTRANSFERASE (GGTP) 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.
High values should be evaluated by your health care provider.
TRANSAMINASE, AST (SGOT) The AST enzyme1 is found mainly in the heart, liver and muscles. It is released into the blood stream when any of these organs are damaged.
Increased levels are usually associated with liver disease or heart attacks.
TRANSAMINASE, ALT (SGPT) The ALT enzyme1 is found mainly in the liver.
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.
CHOLESTEROL is 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. If elevated, the result should be discussed with your health care provider.
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.
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.
CHOLESTEROL/HDL 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 are 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.
hsCRP (HIGHLY SENSITIVE C-REATIVE 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.
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.
(Optional Blood Screening For Males)
PROSTATIC SPECIFIC ANTIGEN (PSA) is 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, all elevated values should be reported to your health care provided for further evaluation.
Complete Blood Count (CBC)
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
- 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.
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.
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 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 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.
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.
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.
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.