Lab Test Results Mean
One of the most frightening things learned in veterinary school was that blood results are not really abnormal until the body is 70% sick. I found that to be true in my own health as well. When I first started on my path toward becoming a naturopath, I knew I had pre-cervical cancer, was depressed and wanted to die. Yet, only one liver enzyme was a bit out of whack. How could this be? And what surprised me most was how normal the rest of my results were. Well, I've corrected all those abnormal results and have my life back. I also have a whole new bag of tricks at my disposal.
Another thing found was that clients had no idea what their lab results meant (or their pet's lab results), what a "rule out" was, or what they could do naturally to repair the abnormal values.
Another thing found was that clients had no idea what their lab results meant (or their pet's lab results), what a "rule out" was, or what they could do naturally to repair the abnormal values.
Blood Tests:
Reference "normal" ranges and unit measurements can vary from lab to lab (sometimes up to 30% difference). Other factors influencing test results include, dietetic preferences, sex, age, race, species, menstrual cycles, amount of exercise, use of non-prescription drugs (aspirin, cold medications, vitamins, etc.), prescription drugs, alcohol consumption, collection and handling of the specimen. For best comparisons of lab results, tests should be done in the same lab. Always use the normal ranges printed on the lab report of that particular sample.
Blood tests can have false positives and negatives. Interpretation of blood tests takes knowledge of the underlying disease process and experience. If your lab results are outside the normal range, we suggest that you discuss them with your doctor. Often it is not the recent result, but the change from a previous test that is most helpful in trying to place a diagnosis on a condition.
Some tests cost more than others. If you can help the doctor understand why a certain test may be important for you and they can justify it in their mind, you may get to your diagnosis quicker and your insurance may pay for the test saving time, money, and aggravation.
When a doctor evaluates the results of a test, they try to figure out what all the causes could be then "rule out" the ones that don't seem to fit after you add all the other signs and symptoms into the picture. In other words,
There are a number of things that might have caused a high or low level of something, and you need to rule out (by other tests or observations or intuition/gut instinct) several possibilities in attempting to figure out what's really going on.
This is much like putting a jigsaw puzzle together and searching for the exact placement of the pieces to the puzzle. This Sherlock Holmes activity is one of my favorites because I get to add in so many other tidbits of information that the medical system doesn't have time to ask in making a final "jigsaw puzzle" assessment. Below are lists of "Rule Outs" for both high and low levels. You will see a veterinary flare to these as I have put in the rule outs for animals as well. I have included the medical term under each abnormality in parentheses. I have also tried to explain in layman's terms the meaning of many of the scientific jargon.
Still don't understand what a rule out is?
Reference "normal" ranges and unit measurements can vary from lab to lab (sometimes up to 30% difference). Other factors influencing test results include, dietetic preferences, sex, age, race, species, menstrual cycles, amount of exercise, use of non-prescription drugs (aspirin, cold medications, vitamins, etc.), prescription drugs, alcohol consumption, collection and handling of the specimen. For best comparisons of lab results, tests should be done in the same lab. Always use the normal ranges printed on the lab report of that particular sample.
Blood tests can have false positives and negatives. Interpretation of blood tests takes knowledge of the underlying disease process and experience. If your lab results are outside the normal range, we suggest that you discuss them with your doctor. Often it is not the recent result, but the change from a previous test that is most helpful in trying to place a diagnosis on a condition.
Some tests cost more than others. If you can help the doctor understand why a certain test may be important for you and they can justify it in their mind, you may get to your diagnosis quicker and your insurance may pay for the test saving time, money, and aggravation.
When a doctor evaluates the results of a test, they try to figure out what all the causes could be then "rule out" the ones that don't seem to fit after you add all the other signs and symptoms into the picture. In other words,
There are a number of things that might have caused a high or low level of something, and you need to rule out (by other tests or observations or intuition/gut instinct) several possibilities in attempting to figure out what's really going on.
This is much like putting a jigsaw puzzle together and searching for the exact placement of the pieces to the puzzle. This Sherlock Holmes activity is one of my favorites because I get to add in so many other tidbits of information that the medical system doesn't have time to ask in making a final "jigsaw puzzle" assessment. Below are lists of "Rule Outs" for both high and low levels. You will see a veterinary flare to these as I have put in the rule outs for animals as well. I have included the medical term under each abnormality in parentheses. I have also tried to explain in layman's terms the meaning of many of the scientific jargon.
Still don't understand what a rule out is?
The Basic Blood Chemistry Panel (Also called a Panel, Serum Chemistry Panel, Chemistry Screen, BMP or Basic Metabolic Panel): For these tests, blood is drawn from the patient who has been fasting 12 hours or more. Three tubes of blood are usually drawn from a vein in t
he arm (human) or neck (animals).
Alanine (ALT, Alanine aminotransferase--formerly known as SGPT). ALT is an enzyme contained inside the fluid part of each liver cell. The larger the number of cells that are damaged, the higher the number. This test is a good indicator of acute disease (disease coming on quickly), but not for chronic liver diseases like cirrhosis where the cells have died and been replaced by fibrous tissue. ALT stays in the blood stream for about 60 hours. Because of this, sometimes your doctor will want to repeat the blood test to track how the body is responding.
ALT Too High (Liver enzymes elevated): Rule out hepatocellular (liver cell) diseases such as cancer, fatty liver, cell death due to bacteria/viruses/hepatitis or toxins, cirrhosis, obstructive jaundice, and infectious mononeucleosis.
ALT Too Low: Rule out pyridoxine (Vitamin B6) deficiency.
Albumin and Globulin measures the amount and type of protein in your blood. Albumin and globulin are a general index of overall health and nutrition. Globulin is the "antibody" protein important for fighting disease produced by white blood cells. Albumin contains things like clotting factors, fibrin and binding proteins (much like egg white) and it give the blood more substance.
Albumin/Globulin Too High: Rule out dehydration, diabetes insipidus (low blood sugar diabetics that can't get enough water), antigenic responses, infection, and gammopathies such as lymphosarcoma, multiple myeloma, and FIP--Feline Infectious Peritonitis
Albumin/Globulin Too Low: Rule out malnutrition, overhydration, advanced liver disease, cancer, acute or chronic hemorrhage, kidney disease (nephrosis), burns, multiple myeloma, metastatic carcinomas, heart disease, loss of blood or protein into the body cavity, malabsorption, parasites and pancreatic atrophy.
False Positives: False elevations can occur with red blood cell damage in the sample (hemolysis) and lipemia (fat in the blood).
Alkaline Phosphatase (Alk. Phos.) Alkaline phosphatase is an enzyme found primarily in bones and the liver but can also be found in other tissues of the body as well such as the intestine, kidney, placenta and in white blood cells. It is thought that this enzyme is increased in the body only when there are actively growing new cells being produced. Alkaline Phosphatase enzymes can be further broken down to find out where they are specifically being produced using a process called electrophoresis (a special test not included in the regular blood panel). The alkaline phosphatase enzyme circulates in the body for about three days before it starts to break down, so if your blood tests are repeatedly high in this area, there are actively growing cells.
Alkaline Phosphatase Too High: Rule outs include gallstones, damage to bones, Paget's disease (a chronic disorder of the adult skeleton in which localized areas of hyperactive bone are replaced by a softened and enlarged osseous structure), rickets, healing fracture, hyperparathyroidism, pulmonary infarction, heart failure, liver disease with too many cells growing (like cancer), obstruction within the liver or the liver not getting what it needs because something is obstructed outside the liver, pancreatitis, severe anemia, lack of oxygen getting to the liver, Cushing's disease, drugs such as glucocorticoids (steroids), primidone, phenobarbital (anti-seizure drugs). An elevated alkaline phosphatase is normal in growing children and in pregnant women.
Alkaline Phosphatase Too Low: Pernicious anemia, hypoparathyroidism, hypophosphatasia and possibly the blood was taken from a collection tube that had EDTA preservative in it.AST (Aspartate aminotransferase--formerly known as SGOT): AST is an enzyme contained in all cells of the body, but is used as a diagnostic marker for liver and muscle damage. Its half-life is about 12 hours.
AST Too High: Rule out liver disease (death of cells and cancer), skeletal muscle diseases, (myositis and muscular dystrophy), trauma, pancreatitis, renal infarct, eclampsia (milk fever), cancer, cerebral damage, seizures, alcohol, heart tissue disease (heart attacks, pericarditis), infections in the bloodstream (septicemia), intramuscular injections, drugs such as corticosteroids, primidone, antibiotics and other drugs processed through the liver. Hemolysis (ruptured red cells from improper handling of the blood) can also raise AST levels.
AST Too Low: Rule out pyridoxine (Vitamin B6) deficiency, and terminal stages of liver disease.
Bilirubin (Bilirubinemia): Most bilirubin (80%) is a breakdown component from dying red blood cells. Bilirubin is also in macrophages of the spleen and in the liver, bone marrow and nonheme porphyrins. Bilirubin travels via the blood stream in the plasma part of the blood surrounded by albumin, globulin and other proteins. As it gets to the liver via the blood system, it disassociates from these proteins and the liver accepts it into it's own cells by binding (conjugating) it with glucuronic acid. This conjugation makes it water-soluble. From here bilirubin gets into the bile and then dumps into the small intestine, eventually leaving though the feces after it changes form one more times. Some of this bilirubin sneaks back into the bloodstream and is reabsorbed into the blood. This happens repeatedly. Sometimes the bilirubin ends up being excreted via the kidneys and dumps out into the urine. When this happens, it shows up in abnormal levels within the blood and may also show up in the urinalysis on the dipstick test.
Bilirubin Too High (Hyperbilirubinemia): Rule outs include hemolytic anemia, pulmonary infarct, Gilbert's syndrome (mild unconjugated hyperbilirubinemia), Dublin-Johnson syndrome (a genetic symptomatic mild jaundice), neonatal jaundice, inadequate liver uptake or defective conjugation, massive internal hemorrhage, obstruction of bile within the liver or outside the liver, defective secretion, acute or chronic hepatitis, fibrosis of the liver and liver cancer. It can also be falsely elevated when there is too much fat in the bloodstream. If only slightly elevated above the expected ranges, but with all other enzymes (LDH, GOT, GPT, GGT) within expected values, it is probably a condition known as Gilbert’s syndrome and is not significant.
Bilirubin is also measured in the urine. Sometimes the doctor's will run a test to check both conjugated and unconjugated bilirubin to help them determine where the extra is coming from.
They want to know if the liver is blocked or the blood cells have broken (hemorrhage). When the liver is blocked totally the fecal material will also be gray or whitish (acholic). When increased bilirubin is caused from hemorrhage the stools will be almost orange in color. You will want to tell your doctor this information because they may not ask.
Bilirubin Too Low: Low values are of no concern. Sunlight and fluorescent lights degrade the sample as the bilirubin is very fragile when exposed to light.
Private Home Health Testing, avoid the doctors office!BUN (Blood Urea Nitrogen, Urea Nitrogen): High values may mean that the kidneys are not working as well as they should in clearing out the breakdown products of digested protein. The major breakdown product of protein you eat is urea, which is first formed in the liver. Urea contains nitrogen and together, in excess quantity, they are both toxic to the body and must be removed. Kidneys normally do an excellent job of removing urea, but when they start to fail, the urine components get all backed up in the system and the blood concentration of urea begins to rise. If you smell the breath, it has a stale, sickly smell (see my handout on the causes of Halitosis for other characteristics of bad breath) The reference range (or range within which most normal people's test values fall) for BUN is 10-20 mg/dl.
BUN Too High (Uremia, Azotemia or Uremic Acidosis): Rule out dehydration (too little water in the tissues), too much exercise, shock due to too much blood being lost (hemorrhagic shock), pancreatitis, intestinal foreign body, adrenal cortical insufficiency (adrenal glands not producing enough of the hormones it is suppose to be producing), or any condition which decreases blood flow to the kidneys, glomerulonephritis (the little tubules that make the urine in the kidneys are swollen and not working right), amyloidosis (the kidney tissue is being replaced with some kind of unnatural protein), pyelonephritis (inflammation/infection of the kidney where the urine pools before it dumps out into the ureters), nephrosis (a condition of the kidneys), calcium nephropathy--also called lymphosarcoma (cancer of the kidneys where the tissues are being replaced by calcium so the urine can't get out), kidney cancers, obstruction of the urine coming out of the kidney, leukemia, heart failure, ruptures of the urine carrying parts (kidney, ureters, bladder, urethra, kidney tubules), too much protein in the diet, bleeding within the intestine, and drugs like amphotericin B. Often, an additional test is done to measure creatinine.
BUN Too Low: Severe liver disease, hepatic venous shunts (portal-caval shunts), anorexia for several days (starving, not eating, fasting), pregnancy.
BUN/Creatinine Ratio: This test is used to differentiate kidney disease from dietary protein metabolism problems. Considered together, the BUN, blood creatinine and their ratio give very good evidence of the filtering function of the kidneys and a measure of the degree of bodily hydration. The ratio of BUN: creatinine is normally 10:1.
BUN/Creatinine Ratio Too High: Rule out dehydration (if the ratio is 20:1 or even higher), certain types of kidney disease, breakdown of blood in the intestinal tract, increased dietary protein, and any clinical circumstance in which insufficient blood is flowing through the blood vessels to the kidneys (such as heart failure or kidney artery disease)..
BUN/Creatinine Ratio Too Low: Rule out certain types of kidney disease, liver disease, malnutrition and Sickle Cell Anemia.
C-Peptide (see under Glucose)
Calcium is controlled in the blood by the parathyroid glands and the kidneys. Calcium is found mostly in bone and is important for proper blood clotting, nerve, and cell activity. Calcium is also found in the bloodstream.
Calcium Too High (Hypercalcemia): Rule out an elevation due to medications such as thiazide-type diuretics, inherited disorders of calcium handling in the kidneys, diets containing too much calcium, too many calcium supplements, too much Vitamin D, multiple myeloma (cancer of the stem cells within the bone that are responsible for producing all types of red and white cells), bone cancer, sarcoid, too much protein in the blood, too much albumin in the blood, fat in the blood (lipemia), excess parathyroid gland activity such as primary hyperparathyroidism (the thyroid gland has some kind of tumor or cancer causing the calcium levels to be to high), and pseudohyperparathyroidism (cancer of the lymphatic system).
Calcium Too Low (Hypocalcemia): Rule out certain drugs like Fosamax and furosemide-type diuretics, not enough dietary calcium, not enough dietary Vitamin D, overhydration, malabsorption, nutritional secondary hypoparathyroidism, hypercalcitoninism, eclampsia (milk fever--the baby or muscle contractions during birth have used up too much of the calcium), pancreatitis with fat necrosis (an infection in the pancreas which has affected all the extra fat in the body causing it to die from lack of circulation and nutrition), and not enough protein or albumin in the blood. Calcium is bound to a particular type of blood protein called albumin in the blood, so a low albumin level will cause the total calcium level in the blood to drop in proportion.
Cholesterol. There are two types of cholesterol, those obtained from the diet (exogenous) and that produced within the body (endogenous). Most of the endogenous cholesterol is formed by the liver, but each cell also produces a little bit as well which makes up part of the cellular membrane. With just small modifications, cholesterol can be used as the body needs it as steroids and cholic acid. Cholic acid uses approximately 80% of the body's cholesterol, which is converted into bile--that substance that helps us digest fats. Cutting out saturated fats from your diet can decrease your cholesterol levels from 15-25%. Eating more unsaturated fats (oils, nuts, seeds) can decrease your cholesterol. The saturated and unsaturated fats fight for the same receptor sites on cells. Saturated fats make the cell membranes sluggish (so you get arthritis and other degenerative diseases) and unsaturated fats make the membranes more liquid so the body works better. Lack of insulin and thyroid hormones will also increase the cholesterol levels.
Cholesterol is further broken down as follows:
Total Cholesterol: High cholesterol in the blood is a major risk factor for heart and blood vessel disease. Cholesterol in itself is not all bad. In fact, our bodies need a certain amount of this substance to function properly. However, when the level gets too high, vascular disease can result. Total cholesterol of less than 200, and an LDL Cholesterol of 100 or less is considered optimal by the National Heart, Lung, and Blood Institute. As the level of blood cholesterol increases, so does the possibility of plugging the arteries due to cholesterol plaque build-up. This is called "hardening of the arteries" or atherosclerosis. When the arteries feeding the heart become plugged, a heart attack may occur. If the arteries that go to the brain are affected, a stroke occurs.
There are three major kinds of cholesterol, High Density Lipoprotein (HDL) , Low Density Lipoprotein (LDL), and Very Low Density Lipoprotein (VLDL). The lower the density of cholesterol, the more cholesterol molecules there are.
HDL (High Density Lipoprotein) cholesterol is a "good cholesterol" as it protects against heart disease by helping remove excess cholesterol deposited in the arteries. High levels seem to be associated with low incidence of coronary heart disease.
LDL (Low Density Lipoprotein) cholesterol is considered to be "bad cholesterol" because cholesterol deposits form in the arteries when LDL levels are high. LDL levels of less than 130 are recommended. One hundred is optimal and values greater than 160 are considered high risk. Those persons who have established coronary or vascular disease may be instructed by their doctor to get their LDL cholesterol well below 100. You should ask your doctor which LDL target he or she wants for you.
There are two ways to report LDL. The most common is simply an estimate calculated from the Total Cholesterol, HDL, and triglycerides results. This may read "LDL Calc" on your results . A directly measured LDL cholesterol is usually more accurate, but more expensive and may require that your doctor specify the Direct LDL test.
VLDL (Very Low Density Lipoprotein: This is the only lipoprotein initially formed in the liver and contains mostly triglycerides and very little phospholipids and cholesterol. As they flow through the blood vessels they are quickly broken up and used as energy or stored as fat.
Cholesterol Too High: Rule out hypothyroidism, obstructive jaundice, liver disease, nephrosis, diabetes mellitus, familial, pancreatitis, hyperadrenocorticism, diet, retained anger and resentment.
Cholesterol Too Low: Rule out hyperthyroidism, infection, malnutrition, heart failure, malignancies, low fat diet, intestinal malabsorption and hepatic insufficiency.
Creatinine. (Also known as Creatine phosphokinase, CK and CPK) is an enzyme which is very useful for diagnosing diseases of the heart and skeletal muscle. This enzyme is the first to be elevated after a heart attack. If CPK is high in the absence of heart muscle injury, this is a strong indication of skeletal muscle disease. Most creatinine is produced in the muscle, heart and brain. Creatinine is a water-soluble waste product largely from muscle breakdown that is excreted via the kidney tubules. Creatinine is not affected by the amount of urine produced and excreted. When creatinine breaks down it gives us energy because it acts as an enzyme important in the process of forming ATP (that very basic process that gives us energy).
The rule outs for too high and too low creatinine levels are the same as for BUN (Blood Urea Nitrogen): If the kidneys are not functioning properly, the concentrations of creatinine and blood urea nitrogen will rise in the blood. The laboratory uses the blood urea nitrogen (BUN) and creatinine levels to assess kidney function. In addition, a urinalysis is used to measure kidney output function and health of the collecting system (lower portion of kidney, ureters and bladder).
Creatinine Too High: Rule out dehydration, too much exercise, hemorrhagic shock (shock due to too much blood being lost), pancreatitis, intestinal foreign body, too much protein in the diet, bleeding within the intestine, drugs like amphotericin B, hyperthyroidism (humans) and hypothyroidism (animals-sometimes), adrenal cortical insufficiency (adrenal glands not producing enough of the hormones it is suppose to be producing), any condition which decreases blood flow to the kidneys such as, glomerulonephritis (the little tubules that make the urine in the kidneys are swollen and not working right), amyloidosis (the kidney tissue is being replaced with some kind of unnatural protein), pyelonephritis (inflammation/infection of the kidney where the urine pools before it dumps out into the ureters), nephrosis (a condition of the kidneys), calcium nephropathy--also called lymphosarcoma (cancer of the kidneys where the tissues are being replaced by calcium so the urine can't get out and so it builds up in the body instead), kidney cancers, obstruction of the urine coming out of the kidney, ruptures of the urine carrying parts (kidney, ureters, bladder, urethra, kidney tubules.)
Creatinine Too Low: Rule out severe liver disease, hepatic venous shunts (portal-caval shunts), anorexia for several days (starving, not eating, fasting), and pregnancy.
GGT (Gamma glutamyltransferase or Gamma glutamyl transpeptidase) is an enzyme that is in high levels specifically in kidney tubule cells and in bile producing cells of the liver. When it shows up in high levels in the blood serum, it is of liver origin. When it if from the kidneys, a special test needs to be run to see it, so this one can be missed because it is not a part of routine blood work.
GGT Too High: Rule out liver disease, particularly with obstruction of the bile ducts (cholestasis) and in acute hepatic necrosis (liver cells dying and rotting very quickly). Unlike alkaline phosphatase it is not elevated with bone growth or damage.
C-peptide : This is a fragment cleaved off of the precursor of insulin (pro-insulin) when insulin is manufactured in the pancreas. C-peptide levels usually correlate with the insulin levels, except when people take insulin injections. When a patient is hypoglycemic, this test may be useful to determine whether high insulin levels are due to excessive pancreatic release of insulin, or from an injection of insulin.
LDH (Lactate Dehydrogenase) is the enzyme present in all the cells of the body. Anything that damages cells, including blood drawing itself, will raise amounts in the blood. If blood is not processed promptly and properly, high levels may occur.
Lactate Dehydrogenase Too High: Rule out heart attack, pulmonary infarction, hemolytic anemia, pernicious anemia, leukemia, lymphoma, malignancies, renal infarction, seizures, cerebral damage, trauma, sprue (a chronic intestinal malabsorption disorder caused by gluten intolerance), lymphosarcoma, lipemia (fat in the bloodstream), improper sample handling (broken cells), necrosis (tissue death) of the liver, skeletal muscle, kidney, pancreas and myocardium and using old blood samples for running the test.
Note: If all values except LDH are within expected ranges, it is probably a processing error and does not require further evaluation.
Lactate Dehydrogenase Too Low: Not clinically significant.
Phosphorus is a mineral largely stored in the bone and is regulated by the kidneys.
Phosphorus Too High (Hyperphosphatemia): Rule out kidney disease, normal in young animals, high protein diets, too much Vitamin D, hypoparathyroidism, diabetic acidosis, acromegaly, Addison's disease, calcium nephropathy, lymphosarcoma (if BUN is also elevated), and not allowing the blood tube to clot before separating the serum from the sample before mailing.
Phosphorus Too Low (Hypophosphatemia): Rule out inadequate diet, malabsorption, parathyroid conditions such as primary hyperparathyroidism and pseudohyperparathyroidism, Vitamin D deficiency, osteomalacia, rickets, Fanconi syndrome, cirrhosis, hypokalemia, excess IV glucose, too much insulin in the system (either from injection or cancer of the pancreas). When low levels of phosphorus are seen with high levels of calcium it suggests parathyroid disease.
Potassium: Potassium is an essential mineral controlled very carefully by the kidneys. It is important for the proper functioning of the nerves and muscles, particularly the heart. Any value outside the expected range, high or low, requires medical evaluation. This is especially important if you are taking a diuretic (water pill) or heart pill (Digitalis, Lanoxin, etc.).
Potassium Too High (Hyperkalemia): Rule out Addison's disease (adrenal cortical insufficiency), dehydration, cardiac arrhythmia, severe renal disease, hyperkalemic acidosis, diabetic acidosis, hypoadrenalism, hereditary hyperkalemia, metabolic acidosis (like in diabetes mellitus).
Note: Hemolyzed blood will also cause a slight increase in potassium because 85% of all the potassium in the body is stored within the cells. Hemolyzed blood can happen when the sample is damaged and the blood cells have broken in the process of either collecting the sample or in handling the vials during transport to the lab. I have also seen it occur when the syringe is pulled back too quickly or too far causing the vein to collapse (impatience). This doesn't happen often in humans because a needle is inserted into the arm vein and the tube pushed onto the needle. In this way the blood does not suck into the tubes too quickly and the sample stays intact (animals are not that cooperative, so that's another story).
Potassium Too Low (Hypokalemia): Rule out cirrhosis, malnutrition, metabolic alkalosis, nephrosis, hyperadrenalism, familial periodic paralysis (need DNA testing for this), overhydration with potassium low fluids, diarrhea, vomiting, intestinal obstruction, malabsorption, Cushing's disease, insulin treatments driving potassium into the cells, drugs such as mercurial diuretics and hydrochlorothiazide (blood pressure medications).
Sodium: Sodium is an essential mineral regulated by the kidneys and adrenal glands and present in every cell of our body.
Sodium Too High (Hypernatremia): Rule out dehydration, heart disease, salt poisoning, eating too many salty foods, faulty water softener dumping too much salt into the water, and diabetes insipidus.
Sodium Too Low (Hyponatremia): Rule out Addison's disease (adrenal cortical insufficiency), diarrhea, overhydration with fluids not containing salt, malabsorption, diabetic acidosis, severe renal disease, ruptured or obstructed urinary system, overdose of certain drugs such as diuretics and blood pressure medications (like hydrochlorothiazide), excess antidiuretic hormone, nephrosis, hypoadrenalism, myxedema, congestive heart failure, vomiting, diabetic acidosis, and excessive water intake in patients with heart or liver disease.
Total protein in the blood includes clotting factors, enzymes, antibodies, transport substances, albumin and most of the alpha and beta globulins. Total protein is measured in grams/deciliter with an instrument called a refractometer. A refractometer is a machine that can measure how much light passes through a substance.
Protein Too High (Hyperproteinemia): Rule out dehydration, too much albumin and fibrin, globulin increases from tissue injury, inflammation, active liver disease, strongylosis (roundworm infestation), immune-mediated disease, lymphoid neoplasms, and myelomas (bone cancer). Factors giving false elevations include abnormally high concentrations of glucose, urea, sodium, chloride or lipids. Hemolysis (but not icterus) also causes mild elevations.
Protein Too Low (Hypoproteinemia): Rule out decreased production, intestinal malabsorption, malnutrition, exocrine pancreatic insufficiency, chronic liver disease, accelerated loss of protein, hemorrhage, renal disease (proteinuria), protein-losing enteropathies, severe exudative skin disease, burns, high-protein effusions, hepatic insufficiency, colostrum deprivation, combined immunodeficiency (foals), agammaglobulinemia, selective IgM deficiency, transient hypogammaglobulinemia, and Disseminated Intravascular Coagulation (DIC).
Triglycerides (also called Neutral Fat): Triglycerides (along with carbohydrates) are fats in the blood used in the body mainly to provide energy for the different metabolic processes. Those that are not used for energy are quickly stored as fat.
Triglycerides Too High: Rule out post-prandial (just after eating they go up), heart disease (severe elevations), endocrine, hepatic, pancreatic and renal disease, high-fat diets, low insulin, hypothyroid, heparin injections, diabetes mellitus, and exogenous corticosteroids.
Uric Acid is a breakdown product of nucleic acids normally excreted in urine. Nucleic acids make up the components of DNA and RNA in our bodies.
Uric Acid Too High: Rule out gout, arthritis, kidney problems leukemia, lymphoma, polycythemia, acidosis, psoriasis, hypothyroidism, eclampsia, multiple meyeloma, pernicious anemia, tissue necrosis, inflammation, and the use of some diuretics.
Uric Acid Too Low: Rule out uricosuric drugs (drugs that break down uric acid and assist it to leave via the urine--as your pharmacist on this), too much allopurinol (the drug used in the treatment of gout), Wilson's Disease (a genetic disease of the liver which allows copper to build up to toxic levels), and large doses of Vitamin C.
Bile Acids: Bile acids produced by the liver cells. They are bound by the amino acids glycine or taurine and then dumped into the bile. Bile acids help us to digest our foods--especially the fatty ones. Sometimes I see people (and cats) that have vision problems and enlarged hearts who test out as having taurine deficiency so there may be an association. I don't know for sure.
Bile Acids Too High (Increased bile acids): Rule out blocked bile ducts (gall stones?), acute toxic hepatic necrosis, anicturic liver disease, alcoholic liver disease, biliary atresia, chemical and drug induced liver injury, cirrhosis, cholestasis, cystic fibrosis, generalized pruritis (itchy rash all over the body), hepatoma, nausea and vomiting associated with pregnancy, neonatal hepatitis, protracted diarrhea in infants, Reye's syndrome, and viral hepatitis.
Bile Acids Too Low: Not clinically significant.
The Complete Blood Count (CBC): When all the cellular components of the blood are looked at and characterized as to their numbers this is called a Complete Blood Count or CBC. Within the CBC the white cells, red cells and platelets are counted. A white cell count is called a WBC (White Blood Cell count) and a red cell count is called an RBC (Red Blood Cell count). The CBC typically has several parameters that are created and evaluated using an automated cell counter. These are the most relevant:
WBC (White Blood Count)
White blood cells are responsible for detecting and destroying diseases that come into our body. There are several ways to measure white blood cells. White cells are also broken down into their individual categories of types of cells that fight different things. These include Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils. Most times these cells are counted by automation (machine), but sometimes the doctor would like to see the character of the cells to detect any differences that the machine can't detect with it's mechanism, so a hand count is done and abnormalities noted.
White Blood Count Too High: Rule out infection and leukemia.
White Blood Count Too Low: Rule out bone marrow diseases or an enlarged spleen, pooling of the cells within the body (like in pyometra), HIV (Note: The vast majority of low WBC counts in our population is NOT HIV related.)
Neutrophils: Neutrophils are a type of white blood cell that circulate in both tissues and blood. They act like little "Pac Men" in the tissues finding bacteria and chomping them up. Once they move from the circulation into the tissues, they don't return. They are replaced two times or more each day, so you can see that these cells can really multiply when there is a problem.
Neutrophils Too High: Rule out stress, pain, very high or very low body temperatures (which cause cortisol to be released from the system), drugs such as cortisone, strenuous exercise, bacterial infections (cat bite abscesses are a fabulous representation of this!), increased heart rate and increased blood pressure. When neutrophils increase with stress (called a stress leukogram), the neutrophil count goes up and the leukocyte count decreases at the same time.
Lymphocytes: Lymphocytes live in the immune rich tissues like the lymph nodes, spleen, tonsils, thymus, gastrointestinal lymphoid tissue, bronchial lymphoid tissue, bone marrow and in the blood. There are lots of lymph nodes in the breast, under the arm, behind the knees, in the neck, and in the groin areas. Lymphocytes are specifically attracted to viruses, pollens and cells that have anything wrong on them on the outside of the cell (this is called cell-mediated immunity). They live a lot longer (weeks) than neutrophils and DO recirculate from the tissue to the blood and back. They go where they are needed. Lymphocytes are further broken down into T-cells, and B-cells, but special testing is needed to determine how much of each we have.
T-cells have the ability to never forgive and never forget. When they detect something bad in the system they attack it. If a particular T cell was programmed to attack the cancer virus, it will always attack cancer virus (and not much else). Sometimes these particular cancer-attacking white cells are called "Killer cells". We stimulate our immune system to train the T-cells by using vaccines, homeopathic nosodes, and exposing ourselves to infectious agents. This makes our immune system strong.
B-cells wait around for orders. They will turn into T cells if necessary, but most times their job is to produce antibodies. Antibodies glom onto foreign substances that get into the body and they remove it. When antibodies get the wrong orders (like when a person is highly allergic to bee stings), the B cells sometimes overreact or react too quickly causing anaphylactic shock.
Lymphocytes Too Low (Lymphopenia): Rule out corticosteroids, stress, pain, acute systemic infections (viral and bacterial), acquired T lymphocyte deficiency (neonatal infections), immunosuppressive drugs, irradiation, loss of lymph, chylous thoracic effusion (ruptured thoracic duct), lymphosarcoma, enteric neoplasms, granulomatous enteritis, Johne's disease (cattle), protein-losing enteropathies, ulcerative enteritis, lymphatic cancer destroying lymph nodes, and hereditary T-cell deficiency.
Monocytes: Monocytes can be elevated (monocytosis) in response to corticosteroids, with pus conditions (abscesses), necrosis, malignancy, hemolysis, hemorrhage, mononucleosis, immune injury, pyogranulomatous diseases, and in acute and chronic stages of disease.
Eosinophils: Eosinophils are elevated (eosinophilia) with parasite infestation, allergies, myositis, canine and feline eosinophilic granuloma complex, eosinophilic gastroenteritis, panosteitis, milk sensitivity (cattle), feline staphylococcal or streptococcal infections and mast cell neoplasia.
Basophils: Basophils are the least numerous of the white blood cells. Observing even a few cells on the blood smear usually attracts attention.
Basophils Too High (Basophilia): Rule out parasites, hypersensitivities, heartworm (without microfilaria in the blood), altered plasma lipoprotein metabolism causing endocrine diseases, nephrotic syndrome, chronic liver disease, genetic hyperlipoproteinemias, and mastocytomas (Mast cells look much like basophils).
Platelet Count (PLT or Thrombocyte count): Platelets are cells that plug up holes in blood vessels and prevent bleeding. This test measures the number of platelets in a drop (microliter) of blood. Normal values range from 150,000 to 400,000 platelets per microliter. A count below 50,000 can result in spontaneous bleeding; below 5,000, patients are at risk of severe life-threatening bleeding.
Platelet Count Too High (Thrombosis): Rule out bleeding, cigarette smoking, excess production by the bone marrow, strenuous activity, myeloproliferative disorders, infections, inflammation, cancers, and when the spleen has been removed.
Platelet Count Too Low (Thrombocytopenia): Rule out premature destruction states such as immune-mediated thrombocytopenia, acute blood loss, drug effects (such as heparin), infections with sepsis, entrapment of platelets in an enlarged spleen, or bone marrow failure from diseases such as myelofibrosis or leukemia. Platelet counts decrease just before menstruation. If there are not enough platelets in your blood, you may notice signs of bleeding such as nosebleeds, easy bruising, prolonged bleeding from a cut, black or bloody stools, brown or red urine, or tiny pinpoint sized red or purple spots on your skin, under your nails or in your gums (petechial hemorrhage). Low platelets also can occur from clumping of the platelets in a lavender-top tube. You may need to repeat the test with a green top tube in th case.
RBC (Red Blood Count)
Hemoglobin (Hgb): Hemoglobin is the amount of oxygen carrying protein contained within the red blood cells.
Hemoglobin Too High: Rule out lung disease, living at high altitude, excessive bone marrow production of blood cells, kidney tumors, hepatomas (liver tumors), uterine leiomyomas, cerebellar hemangioblastomas, and sickle cell anemia
Hemoglobin Too Low: Rule out anemia due to nutritional deficiencies, blood loss, destruction of blood cells internally, or failure to produce blood in the bone marrow.Hematocrit (Hct, Packed Cell Volume or PCV): The hematocrit is the percentage of the blood volume occupied by red blood cells. Men have a slightly higher hematocrit percentages than women because women lose a bit of blood each month during their menstrual cycle.
Hematocrit Too High: Rule out smoking (due to too much carbon dioxide exposure), high altitude, chronic lung disease, and newborn syndrome.
Hematocrit Too Low: Rule out anemia due to nutritional deficiencies, blood loss, and destruction of blood cells internally, or failure to produce blood in the bone marrow.MCH (Mean Corpuscular Hemoglobin or Mean Corpuscular Volume (MCV) - This test helps diagnose the type of anemia.
MCH Too High: Rule out B12 deficiency, folate deficiency, ineffective production in the bone marrow, or recent blood loss with replacement by newer (and larger) reticulocytic cells from the bone marrow, and in vitro or in vivo hemolysis.
MCH Too Low: Rule out iron deficiency,MCHC (Mean Corpuscular Hemoglobin Content or concentration) denotes the volume and character of the hemoglobin and is the most accurate of the red cell indices.
MCHC Too High: Rule out spherocytosis (the cells are old and not being replaced as often), and in vitro or in vivo hemolysis.
MCHC Too Low: Rule out reticulocytes (too many young red cells), and iron deficiency.RDW (Red cell Distribution Width) This test measures the different sizes and shapes of the red cell. RDW is important because the more surface area the red cell has, the better it can hook onto and transport oxygen through the system.
RDW and MCV both Too High: Rule out liver disease, hemolytic anemia, Vitamin B12 deficiency, folic acid deficiency.
RDW Too High, but MCV Too Low: Rule out iron deficiency anemia, thalessemia intermedia (defective hemoglobin), fragmented cells.
RDW Too High, but MCV Normal: Rule out low Vitamin B12 or folic acid, iron deficiency anemia (early stages)
RDW Too Low: Rule out macrocytic anemia (red cells are too large), microcytic anemia (red cells too small). When the cells are all the same size, the RDW level will be low.
Note: One simple way to tell if you are anemic is to look at your cheeks and chin in the mirror. If they look like they have a blotchy tan, you are anemic and it will show up on a test within two weeks. My recommendation is to take about 3/4 tea. blackstrap molasses every day for a couple of months. When the anemia is gone, the tan will be too.
Blood Gasses: Blood gasses measure how much influence oxygen, carbon dioxide and hydrogen ion concentration (pH) has on our body. This sample has to be taken from an artery to accurately measure the oxygen content. The other blood samples are taken from veins and both pH and CO2 can be measured using venous blood. Blood gasses should be evaluated immediately.
Oxygen (PO2): The total oxygen concentration depends on total hemoglobin, oxygen-carrying capability of hemoglobin, body temperature, blood pH, certain blood enzymes and PO2 itself.
Oxygen Too High: Rule out gasses with high oxygen content (oxygen cages and anesthetic machines).
Oxygen Too Low (Hypoxia): Rule out respiratory disorders, heart shunts, or brain damage.
Carbon Dioxide (CO2) reflects the acid status of the blood and is a measure of the exchange of oxygen between the alveoli of the lungs.
Carbon Dioxide Too High: Rule out increased ventilation.
Carbon Dioxide Too Low: Rule out decreased ventilation, increased acidity from uncontrolled diabetes, kidney disease, heart shunts, and metabolic disorders.
Bicarbonate (HCO3-): Bicarbonate is maintained in health by conservation and production by the renal tubules, so if there is kidney disease of some kind, the values may be abnormal.
Cardiac Risk Factors
C Reactive Protein (CRP): This is a marker for inflammation.
C Reactive Protein Too High: Rule out inflammation in response to infection, vascular disease, heart attacks or strokes.
Homocysteine: Homocysteine is an amino acid that is normally found in small amounts in the blood. Higher levels are associated with increased risk of heart attack and other vascular diseases. Men tend to have higher levels.
Homocysteine Too High: Rule out folic acid deficiency, Vitamin B12 deficiency, heredity, aging, kidney disease, and certain medications. Lipoprotein or Lp: Lipoproteins are a combination of water-soluble proteins containing cholesterol and triglycerides and are present in the blood. The lipoproteins in this test break the lipoprotein down into its alpha or beta forms and determines the volumes of each. (Also see Cholesterol above).
Lipoproteins are also contained in the cholesterols high-density (HDL), low density (LDL), and very low density (VLDL) lipoproteins which are all factors in heart disease and cholesterol levels. These have been discussed under their individual cholesterol categories above.
Too High: Rule out premature coronary heart disease (CHD) and the genetic link to heart disease. Persons with diabetes and a high Lp level appear to have increased risk of asymptomatic coronary disease.
Thyroid Tests:To evaluate the thyroid your doctor will take blood to run a Thyroid Function Blood Panel, which will include many of the tests below depending on the doctor's education and the tests available at the laboratory. It is important to understand each test because there is a lot of confusion among doctors, nurses, lab technicians, and patients as to which test is which. In particular, the "Total T3", "Free T3" and "T3 Uptake tests" are very confusing, and are not the same test.
There ARE other options besides medications. For example, cholesterol. It can be abnormal for a variety of reasons, but it is often repaired so easily with natural products such as Chitosan.
Because I saw a need for this information, I sat down and compiled this handout. It took me three solid weeks to do it. I hope you get some useful information from it, and that you think about making an appointment with myself when it comes to deciding upon which option you will choose on your path to wellness.
he arm (human) or neck (animals).Alanine (ALT, Alanine aminotransferase--formerly known as SGPT). ALT is an enzyme contained inside the fluid part of each liver cell. The larger the number of cells that are damaged, the higher the number. This test is a good indicator of acute disease (disease coming on quickly), but not for chronic liver diseases like cirrhosis where the cells have died and been replaced by fibrous tissue. ALT stays in the blood stream for about 60 hours. Because of this, sometimes your doctor will want to repeat the blood test to track how the body is responding.
ALT Too High (Liver enzymes elevated): Rule out hepatocellular (liver cell) diseases such as cancer, fatty liver, cell death due to bacteria/viruses/hepatitis or toxins, cirrhosis, obstructive jaundice, and infectious mononeucleosis.
ALT Too Low: Rule out pyridoxine (Vitamin B6) deficiency.
Albumin and Globulin measures the amount and type of protein in your blood. Albumin and globulin are a general index of overall health and nutrition. Globulin is the "antibody" protein important for fighting disease produced by white blood cells. Albumin contains things like clotting factors, fibrin and binding proteins (much like egg white) and it give the blood more substance.
Albumin/Globulin Too High: Rule out dehydration, diabetes insipidus (low blood sugar diabetics that can't get enough water), antigenic responses, infection, and gammopathies such as lymphosarcoma, multiple myeloma, and FIP--Feline Infectious Peritonitis
Albumin/Globulin Too Low: Rule out malnutrition, overhydration, advanced liver disease, cancer, acute or chronic hemorrhage, kidney disease (nephrosis), burns, multiple myeloma, metastatic carcinomas, heart disease, loss of blood or protein into the body cavity, malabsorption, parasites and pancreatic atrophy.
False Positives: False elevations can occur with red blood cell damage in the sample (hemolysis) and lipemia (fat in the blood).
Alkaline Phosphatase (Alk. Phos.) Alkaline phosphatase is an enzyme found primarily in bones and the liver but can also be found in other tissues of the body as well such as the intestine, kidney, placenta and in white blood cells. It is thought that this enzyme is increased in the body only when there are actively growing new cells being produced. Alkaline Phosphatase enzymes can be further broken down to find out where they are specifically being produced using a process called electrophoresis (a special test not included in the regular blood panel). The alkaline phosphatase enzyme circulates in the body for about three days before it starts to break down, so if your blood tests are repeatedly high in this area, there are actively growing cells.
Alkaline Phosphatase Too High: Rule outs include gallstones, damage to bones, Paget's disease (a chronic disorder of the adult skeleton in which localized areas of hyperactive bone are replaced by a softened and enlarged osseous structure), rickets, healing fracture, hyperparathyroidism, pulmonary infarction, heart failure, liver disease with too many cells growing (like cancer), obstruction within the liver or the liver not getting what it needs because something is obstructed outside the liver, pancreatitis, severe anemia, lack of oxygen getting to the liver, Cushing's disease, drugs such as glucocorticoids (steroids), primidone, phenobarbital (anti-seizure drugs). An elevated alkaline phosphatase is normal in growing children and in pregnant women.
Alkaline Phosphatase Too Low: Pernicious anemia, hypoparathyroidism, hypophosphatasia and possibly the blood was taken from a collection tube that had EDTA preservative in it.AST (Aspartate aminotransferase--formerly known as SGOT): AST is an enzyme contained in all cells of the body, but is used as a diagnostic marker for liver and muscle damage. Its half-life is about 12 hours.
AST Too High: Rule out liver disease (death of cells and cancer), skeletal muscle diseases, (myositis and muscular dystrophy), trauma, pancreatitis, renal infarct, eclampsia (milk fever), cancer, cerebral damage, seizures, alcohol, heart tissue disease (heart attacks, pericarditis), infections in the bloodstream (septicemia), intramuscular injections, drugs such as corticosteroids, primidone, antibiotics and other drugs processed through the liver. Hemolysis (ruptured red cells from improper handling of the blood) can also raise AST levels.
AST Too Low: Rule out pyridoxine (Vitamin B6) deficiency, and terminal stages of liver disease.
Bilirubin (Bilirubinemia): Most bilirubin (80%) is a breakdown component from dying red blood cells. Bilirubin is also in macrophages of the spleen and in the liver, bone marrow and nonheme porphyrins. Bilirubin travels via the blood stream in the plasma part of the blood surrounded by albumin, globulin and other proteins. As it gets to the liver via the blood system, it disassociates from these proteins and the liver accepts it into it's own cells by binding (conjugating) it with glucuronic acid. This conjugation makes it water-soluble. From here bilirubin gets into the bile and then dumps into the small intestine, eventually leaving though the feces after it changes form one more times. Some of this bilirubin sneaks back into the bloodstream and is reabsorbed into the blood. This happens repeatedly. Sometimes the bilirubin ends up being excreted via the kidneys and dumps out into the urine. When this happens, it shows up in abnormal levels within the blood and may also show up in the urinalysis on the dipstick test.
Bilirubin Too High (Hyperbilirubinemia): Rule outs include hemolytic anemia, pulmonary infarct, Gilbert's syndrome (mild unconjugated hyperbilirubinemia), Dublin-Johnson syndrome (a genetic symptomatic mild jaundice), neonatal jaundice, inadequate liver uptake or defective conjugation, massive internal hemorrhage, obstruction of bile within the liver or outside the liver, defective secretion, acute or chronic hepatitis, fibrosis of the liver and liver cancer. It can also be falsely elevated when there is too much fat in the bloodstream. If only slightly elevated above the expected ranges, but with all other enzymes (LDH, GOT, GPT, GGT) within expected values, it is probably a condition known as Gilbert’s syndrome and is not significant.
Bilirubin is also measured in the urine. Sometimes the doctor's will run a test to check both conjugated and unconjugated bilirubin to help them determine where the extra is coming from.
They want to know if the liver is blocked or the blood cells have broken (hemorrhage). When the liver is blocked totally the fecal material will also be gray or whitish (acholic). When increased bilirubin is caused from hemorrhage the stools will be almost orange in color. You will want to tell your doctor this information because they may not ask.
Bilirubin Too Low: Low values are of no concern. Sunlight and fluorescent lights degrade the sample as the bilirubin is very fragile when exposed to light.
Private Home Health Testing, avoid the doctors office!BUN (Blood Urea Nitrogen, Urea Nitrogen): High values may mean that the kidneys are not working as well as they should in clearing out the breakdown products of digested protein. The major breakdown product of protein you eat is urea, which is first formed in the liver. Urea contains nitrogen and together, in excess quantity, they are both toxic to the body and must be removed. Kidneys normally do an excellent job of removing urea, but when they start to fail, the urine components get all backed up in the system and the blood concentration of urea begins to rise. If you smell the breath, it has a stale, sickly smell (see my handout on the causes of Halitosis for other characteristics of bad breath) The reference range (or range within which most normal people's test values fall) for BUN is 10-20 mg/dl.
BUN Too High (Uremia, Azotemia or Uremic Acidosis): Rule out dehydration (too little water in the tissues), too much exercise, shock due to too much blood being lost (hemorrhagic shock), pancreatitis, intestinal foreign body, adrenal cortical insufficiency (adrenal glands not producing enough of the hormones it is suppose to be producing), or any condition which decreases blood flow to the kidneys, glomerulonephritis (the little tubules that make the urine in the kidneys are swollen and not working right), amyloidosis (the kidney tissue is being replaced with some kind of unnatural protein), pyelonephritis (inflammation/infection of the kidney where the urine pools before it dumps out into the ureters), nephrosis (a condition of the kidneys), calcium nephropathy--also called lymphosarcoma (cancer of the kidneys where the tissues are being replaced by calcium so the urine can't get out), kidney cancers, obstruction of the urine coming out of the kidney, leukemia, heart failure, ruptures of the urine carrying parts (kidney, ureters, bladder, urethra, kidney tubules), too much protein in the diet, bleeding within the intestine, and drugs like amphotericin B. Often, an additional test is done to measure creatinine.
BUN Too Low: Severe liver disease, hepatic venous shunts (portal-caval shunts), anorexia for several days (starving, not eating, fasting), pregnancy.
BUN/Creatinine Ratio: This test is used to differentiate kidney disease from dietary protein metabolism problems. Considered together, the BUN, blood creatinine and their ratio give very good evidence of the filtering function of the kidneys and a measure of the degree of bodily hydration. The ratio of BUN: creatinine is normally 10:1.
BUN/Creatinine Ratio Too High: Rule out dehydration (if the ratio is 20:1 or even higher), certain types of kidney disease, breakdown of blood in the intestinal tract, increased dietary protein, and any clinical circumstance in which insufficient blood is flowing through the blood vessels to the kidneys (such as heart failure or kidney artery disease)..
BUN/Creatinine Ratio Too Low: Rule out certain types of kidney disease, liver disease, malnutrition and Sickle Cell Anemia.
C-Peptide (see under Glucose)
Calcium is controlled in the blood by the parathyroid glands and the kidneys. Calcium is found mostly in bone and is important for proper blood clotting, nerve, and cell activity. Calcium is also found in the bloodstream.
Calcium Too High (Hypercalcemia): Rule out an elevation due to medications such as thiazide-type diuretics, inherited disorders of calcium handling in the kidneys, diets containing too much calcium, too many calcium supplements, too much Vitamin D, multiple myeloma (cancer of the stem cells within the bone that are responsible for producing all types of red and white cells), bone cancer, sarcoid, too much protein in the blood, too much albumin in the blood, fat in the blood (lipemia), excess parathyroid gland activity such as primary hyperparathyroidism (the thyroid gland has some kind of tumor or cancer causing the calcium levels to be to high), and pseudohyperparathyroidism (cancer of the lymphatic system).
Calcium Too Low (Hypocalcemia): Rule out certain drugs like Fosamax and furosemide-type diuretics, not enough dietary calcium, not enough dietary Vitamin D, overhydration, malabsorption, nutritional secondary hypoparathyroidism, hypercalcitoninism, eclampsia (milk fever--the baby or muscle contractions during birth have used up too much of the calcium), pancreatitis with fat necrosis (an infection in the pancreas which has affected all the extra fat in the body causing it to die from lack of circulation and nutrition), and not enough protein or albumin in the blood. Calcium is bound to a particular type of blood protein called albumin in the blood, so a low albumin level will cause the total calcium level in the blood to drop in proportion.
Cholesterol. There are two types of cholesterol, those obtained from the diet (exogenous) and that produced within the body (endogenous). Most of the endogenous cholesterol is formed by the liver, but each cell also produces a little bit as well which makes up part of the cellular membrane. With just small modifications, cholesterol can be used as the body needs it as steroids and cholic acid. Cholic acid uses approximately 80% of the body's cholesterol, which is converted into bile--that substance that helps us digest fats. Cutting out saturated fats from your diet can decrease your cholesterol levels from 15-25%. Eating more unsaturated fats (oils, nuts, seeds) can decrease your cholesterol. The saturated and unsaturated fats fight for the same receptor sites on cells. Saturated fats make the cell membranes sluggish (so you get arthritis and other degenerative diseases) and unsaturated fats make the membranes more liquid so the body works better. Lack of insulin and thyroid hormones will also increase the cholesterol levels.
Cholesterol is further broken down as follows:
Total Cholesterol: High cholesterol in the blood is a major risk factor for heart and blood vessel disease. Cholesterol in itself is not all bad. In fact, our bodies need a certain amount of this substance to function properly. However, when the level gets too high, vascular disease can result. Total cholesterol of less than 200, and an LDL Cholesterol of 100 or less is considered optimal by the National Heart, Lung, and Blood Institute. As the level of blood cholesterol increases, so does the possibility of plugging the arteries due to cholesterol plaque build-up. This is called "hardening of the arteries" or atherosclerosis. When the arteries feeding the heart become plugged, a heart attack may occur. If the arteries that go to the brain are affected, a stroke occurs.
There are three major kinds of cholesterol, High Density Lipoprotein (HDL) , Low Density Lipoprotein (LDL), and Very Low Density Lipoprotein (VLDL). The lower the density of cholesterol, the more cholesterol molecules there are.
HDL (High Density Lipoprotein) cholesterol is a "good cholesterol" as it protects against heart disease by helping remove excess cholesterol deposited in the arteries. High levels seem to be associated with low incidence of coronary heart disease.
LDL (Low Density Lipoprotein) cholesterol is considered to be "bad cholesterol" because cholesterol deposits form in the arteries when LDL levels are high. LDL levels of less than 130 are recommended. One hundred is optimal and values greater than 160 are considered high risk. Those persons who have established coronary or vascular disease may be instructed by their doctor to get their LDL cholesterol well below 100. You should ask your doctor which LDL target he or she wants for you.
There are two ways to report LDL. The most common is simply an estimate calculated from the Total Cholesterol, HDL, and triglycerides results. This may read "LDL Calc" on your results . A directly measured LDL cholesterol is usually more accurate, but more expensive and may require that your doctor specify the Direct LDL test.
VLDL (Very Low Density Lipoprotein: This is the only lipoprotein initially formed in the liver and contains mostly triglycerides and very little phospholipids and cholesterol. As they flow through the blood vessels they are quickly broken up and used as energy or stored as fat.
Cholesterol Too High: Rule out hypothyroidism, obstructive jaundice, liver disease, nephrosis, diabetes mellitus, familial, pancreatitis, hyperadrenocorticism, diet, retained anger and resentment.
Cholesterol Too Low: Rule out hyperthyroidism, infection, malnutrition, heart failure, malignancies, low fat diet, intestinal malabsorption and hepatic insufficiency.
Creatinine. (Also known as Creatine phosphokinase, CK and CPK) is an enzyme which is very useful for diagnosing diseases of the heart and skeletal muscle. This enzyme is the first to be elevated after a heart attack. If CPK is high in the absence of heart muscle injury, this is a strong indication of skeletal muscle disease. Most creatinine is produced in the muscle, heart and brain. Creatinine is a water-soluble waste product largely from muscle breakdown that is excreted via the kidney tubules. Creatinine is not affected by the amount of urine produced and excreted. When creatinine breaks down it gives us energy because it acts as an enzyme important in the process of forming ATP (that very basic process that gives us energy).
The rule outs for too high and too low creatinine levels are the same as for BUN (Blood Urea Nitrogen): If the kidneys are not functioning properly, the concentrations of creatinine and blood urea nitrogen will rise in the blood. The laboratory uses the blood urea nitrogen (BUN) and creatinine levels to assess kidney function. In addition, a urinalysis is used to measure kidney output function and health of the collecting system (lower portion of kidney, ureters and bladder).
Creatinine Too High: Rule out dehydration, too much exercise, hemorrhagic shock (shock due to too much blood being lost), pancreatitis, intestinal foreign body, too much protein in the diet, bleeding within the intestine, drugs like amphotericin B, hyperthyroidism (humans) and hypothyroidism (animals-sometimes), adrenal cortical insufficiency (adrenal glands not producing enough of the hormones it is suppose to be producing), any condition which decreases blood flow to the kidneys such as, glomerulonephritis (the little tubules that make the urine in the kidneys are swollen and not working right), amyloidosis (the kidney tissue is being replaced with some kind of unnatural protein), pyelonephritis (inflammation/infection of the kidney where the urine pools before it dumps out into the ureters), nephrosis (a condition of the kidneys), calcium nephropathy--also called lymphosarcoma (cancer of the kidneys where the tissues are being replaced by calcium so the urine can't get out and so it builds up in the body instead), kidney cancers, obstruction of the urine coming out of the kidney, ruptures of the urine carrying parts (kidney, ureters, bladder, urethra, kidney tubules.)
Creatinine Too Low: Rule out severe liver disease, hepatic venous shunts (portal-caval shunts), anorexia for several days (starving, not eating, fasting), and pregnancy.
GGT (Gamma glutamyltransferase or Gamma glutamyl transpeptidase) is an enzyme that is in high levels specifically in kidney tubule cells and in bile producing cells of the liver. When it shows up in high levels in the blood serum, it is of liver origin. When it if from the kidneys, a special test needs to be run to see it, so this one can be missed because it is not a part of routine blood work.
GGT Too High: Rule out liver disease, particularly with obstruction of the bile ducts (cholestasis) and in acute hepatic necrosis (liver cells dying and rotting very quickly). Unlike alkaline phosphatase it is not elevated with bone growth or damage.
C-peptide : This is a fragment cleaved off of the precursor of insulin (pro-insulin) when insulin is manufactured in the pancreas. C-peptide levels usually correlate with the insulin levels, except when people take insulin injections. When a patient is hypoglycemic, this test may be useful to determine whether high insulin levels are due to excessive pancreatic release of insulin, or from an injection of insulin.
LDH (Lactate Dehydrogenase) is the enzyme present in all the cells of the body. Anything that damages cells, including blood drawing itself, will raise amounts in the blood. If blood is not processed promptly and properly, high levels may occur.
Lactate Dehydrogenase Too High: Rule out heart attack, pulmonary infarction, hemolytic anemia, pernicious anemia, leukemia, lymphoma, malignancies, renal infarction, seizures, cerebral damage, trauma, sprue (a chronic intestinal malabsorption disorder caused by gluten intolerance), lymphosarcoma, lipemia (fat in the bloodstream), improper sample handling (broken cells), necrosis (tissue death) of the liver, skeletal muscle, kidney, pancreas and myocardium and using old blood samples for running the test.
Note: If all values except LDH are within expected ranges, it is probably a processing error and does not require further evaluation.
Lactate Dehydrogenase Too Low: Not clinically significant.
Phosphorus is a mineral largely stored in the bone and is regulated by the kidneys.
Phosphorus Too High (Hyperphosphatemia): Rule out kidney disease, normal in young animals, high protein diets, too much Vitamin D, hypoparathyroidism, diabetic acidosis, acromegaly, Addison's disease, calcium nephropathy, lymphosarcoma (if BUN is also elevated), and not allowing the blood tube to clot before separating the serum from the sample before mailing.
Phosphorus Too Low (Hypophosphatemia): Rule out inadequate diet, malabsorption, parathyroid conditions such as primary hyperparathyroidism and pseudohyperparathyroidism, Vitamin D deficiency, osteomalacia, rickets, Fanconi syndrome, cirrhosis, hypokalemia, excess IV glucose, too much insulin in the system (either from injection or cancer of the pancreas). When low levels of phosphorus are seen with high levels of calcium it suggests parathyroid disease.
Potassium: Potassium is an essential mineral controlled very carefully by the kidneys. It is important for the proper functioning of the nerves and muscles, particularly the heart. Any value outside the expected range, high or low, requires medical evaluation. This is especially important if you are taking a diuretic (water pill) or heart pill (Digitalis, Lanoxin, etc.).
Potassium Too High (Hyperkalemia): Rule out Addison's disease (adrenal cortical insufficiency), dehydration, cardiac arrhythmia, severe renal disease, hyperkalemic acidosis, diabetic acidosis, hypoadrenalism, hereditary hyperkalemia, metabolic acidosis (like in diabetes mellitus).
Note: Hemolyzed blood will also cause a slight increase in potassium because 85% of all the potassium in the body is stored within the cells. Hemolyzed blood can happen when the sample is damaged and the blood cells have broken in the process of either collecting the sample or in handling the vials during transport to the lab. I have also seen it occur when the syringe is pulled back too quickly or too far causing the vein to collapse (impatience). This doesn't happen often in humans because a needle is inserted into the arm vein and the tube pushed onto the needle. In this way the blood does not suck into the tubes too quickly and the sample stays intact (animals are not that cooperative, so that's another story).
Potassium Too Low (Hypokalemia): Rule out cirrhosis, malnutrition, metabolic alkalosis, nephrosis, hyperadrenalism, familial periodic paralysis (need DNA testing for this), overhydration with potassium low fluids, diarrhea, vomiting, intestinal obstruction, malabsorption, Cushing's disease, insulin treatments driving potassium into the cells, drugs such as mercurial diuretics and hydrochlorothiazide (blood pressure medications).
Sodium: Sodium is an essential mineral regulated by the kidneys and adrenal glands and present in every cell of our body.
Sodium Too High (Hypernatremia): Rule out dehydration, heart disease, salt poisoning, eating too many salty foods, faulty water softener dumping too much salt into the water, and diabetes insipidus.
Sodium Too Low (Hyponatremia): Rule out Addison's disease (adrenal cortical insufficiency), diarrhea, overhydration with fluids not containing salt, malabsorption, diabetic acidosis, severe renal disease, ruptured or obstructed urinary system, overdose of certain drugs such as diuretics and blood pressure medications (like hydrochlorothiazide), excess antidiuretic hormone, nephrosis, hypoadrenalism, myxedema, congestive heart failure, vomiting, diabetic acidosis, and excessive water intake in patients with heart or liver disease.
Total protein in the blood includes clotting factors, enzymes, antibodies, transport substances, albumin and most of the alpha and beta globulins. Total protein is measured in grams/deciliter with an instrument called a refractometer. A refractometer is a machine that can measure how much light passes through a substance.
Protein Too High (Hyperproteinemia): Rule out dehydration, too much albumin and fibrin, globulin increases from tissue injury, inflammation, active liver disease, strongylosis (roundworm infestation), immune-mediated disease, lymphoid neoplasms, and myelomas (bone cancer). Factors giving false elevations include abnormally high concentrations of glucose, urea, sodium, chloride or lipids. Hemolysis (but not icterus) also causes mild elevations.
Protein Too Low (Hypoproteinemia): Rule out decreased production, intestinal malabsorption, malnutrition, exocrine pancreatic insufficiency, chronic liver disease, accelerated loss of protein, hemorrhage, renal disease (proteinuria), protein-losing enteropathies, severe exudative skin disease, burns, high-protein effusions, hepatic insufficiency, colostrum deprivation, combined immunodeficiency (foals), agammaglobulinemia, selective IgM deficiency, transient hypogammaglobulinemia, and Disseminated Intravascular Coagulation (DIC).
Triglycerides (also called Neutral Fat): Triglycerides (along with carbohydrates) are fats in the blood used in the body mainly to provide energy for the different metabolic processes. Those that are not used for energy are quickly stored as fat.
Triglycerides Too High: Rule out post-prandial (just after eating they go up), heart disease (severe elevations), endocrine, hepatic, pancreatic and renal disease, high-fat diets, low insulin, hypothyroid, heparin injections, diabetes mellitus, and exogenous corticosteroids.
Uric Acid is a breakdown product of nucleic acids normally excreted in urine. Nucleic acids make up the components of DNA and RNA in our bodies.
Uric Acid Too High: Rule out gout, arthritis, kidney problems leukemia, lymphoma, polycythemia, acidosis, psoriasis, hypothyroidism, eclampsia, multiple meyeloma, pernicious anemia, tissue necrosis, inflammation, and the use of some diuretics.
Uric Acid Too Low: Rule out uricosuric drugs (drugs that break down uric acid and assist it to leave via the urine--as your pharmacist on this), too much allopurinol (the drug used in the treatment of gout), Wilson's Disease (a genetic disease of the liver which allows copper to build up to toxic levels), and large doses of Vitamin C.
Bile Acids: Bile acids produced by the liver cells. They are bound by the amino acids glycine or taurine and then dumped into the bile. Bile acids help us to digest our foods--especially the fatty ones. Sometimes I see people (and cats) that have vision problems and enlarged hearts who test out as having taurine deficiency so there may be an association. I don't know for sure.
Bile Acids Too High (Increased bile acids): Rule out blocked bile ducts (gall stones?), acute toxic hepatic necrosis, anicturic liver disease, alcoholic liver disease, biliary atresia, chemical and drug induced liver injury, cirrhosis, cholestasis, cystic fibrosis, generalized pruritis (itchy rash all over the body), hepatoma, nausea and vomiting associated with pregnancy, neonatal hepatitis, protracted diarrhea in infants, Reye's syndrome, and viral hepatitis.
Bile Acids Too Low: Not clinically significant.
The Complete Blood Count (CBC): When all the cellular components of the blood are looked at and characterized as to their numbers this is called a Complete Blood Count or CBC. Within the CBC the white cells, red cells and platelets are counted. A white cell count is called a WBC (White Blood Cell count) and a red cell count is called an RBC (Red Blood Cell count). The CBC typically has several parameters that are created and evaluated using an automated cell counter. These are the most relevant:
WBC (White Blood Count)
White blood cells are responsible for detecting and destroying diseases that come into our body. There are several ways to measure white blood cells. White cells are also broken down into their individual categories of types of cells that fight different things. These include Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils. Most times these cells are counted by automation (machine), but sometimes the doctor would like to see the character of the cells to detect any differences that the machine can't detect with it's mechanism, so a hand count is done and abnormalities noted.
White Blood Count Too High: Rule out infection and leukemia.
White Blood Count Too Low: Rule out bone marrow diseases or an enlarged spleen, pooling of the cells within the body (like in pyometra), HIV (Note: The vast majority of low WBC counts in our population is NOT HIV related.)
Neutrophils: Neutrophils are a type of white blood cell that circulate in both tissues and blood. They act like little "Pac Men" in the tissues finding bacteria and chomping them up. Once they move from the circulation into the tissues, they don't return. They are replaced two times or more each day, so you can see that these cells can really multiply when there is a problem.
Neutrophils Too High: Rule out stress, pain, very high or very low body temperatures (which cause cortisol to be released from the system), drugs such as cortisone, strenuous exercise, bacterial infections (cat bite abscesses are a fabulous representation of this!), increased heart rate and increased blood pressure. When neutrophils increase with stress (called a stress leukogram), the neutrophil count goes up and the leukocyte count decreases at the same time.
Lymphocytes: Lymphocytes live in the immune rich tissues like the lymph nodes, spleen, tonsils, thymus, gastrointestinal lymphoid tissue, bronchial lymphoid tissue, bone marrow and in the blood. There are lots of lymph nodes in the breast, under the arm, behind the knees, in the neck, and in the groin areas. Lymphocytes are specifically attracted to viruses, pollens and cells that have anything wrong on them on the outside of the cell (this is called cell-mediated immunity). They live a lot longer (weeks) than neutrophils and DO recirculate from the tissue to the blood and back. They go where they are needed. Lymphocytes are further broken down into T-cells, and B-cells, but special testing is needed to determine how much of each we have.
T-cells have the ability to never forgive and never forget. When they detect something bad in the system they attack it. If a particular T cell was programmed to attack the cancer virus, it will always attack cancer virus (and not much else). Sometimes these particular cancer-attacking white cells are called "Killer cells". We stimulate our immune system to train the T-cells by using vaccines, homeopathic nosodes, and exposing ourselves to infectious agents. This makes our immune system strong.
B-cells wait around for orders. They will turn into T cells if necessary, but most times their job is to produce antibodies. Antibodies glom onto foreign substances that get into the body and they remove it. When antibodies get the wrong orders (like when a person is highly allergic to bee stings), the B cells sometimes overreact or react too quickly causing anaphylactic shock.
Lymphocytes Too Low (Lymphopenia): Rule out corticosteroids, stress, pain, acute systemic infections (viral and bacterial), acquired T lymphocyte deficiency (neonatal infections), immunosuppressive drugs, irradiation, loss of lymph, chylous thoracic effusion (ruptured thoracic duct), lymphosarcoma, enteric neoplasms, granulomatous enteritis, Johne's disease (cattle), protein-losing enteropathies, ulcerative enteritis, lymphatic cancer destroying lymph nodes, and hereditary T-cell deficiency.
Monocytes: Monocytes can be elevated (monocytosis) in response to corticosteroids, with pus conditions (abscesses), necrosis, malignancy, hemolysis, hemorrhage, mononucleosis, immune injury, pyogranulomatous diseases, and in acute and chronic stages of disease.
Eosinophils: Eosinophils are elevated (eosinophilia) with parasite infestation, allergies, myositis, canine and feline eosinophilic granuloma complex, eosinophilic gastroenteritis, panosteitis, milk sensitivity (cattle), feline staphylococcal or streptococcal infections and mast cell neoplasia.
Basophils: Basophils are the least numerous of the white blood cells. Observing even a few cells on the blood smear usually attracts attention.
Basophils Too High (Basophilia): Rule out parasites, hypersensitivities, heartworm (without microfilaria in the blood), altered plasma lipoprotein metabolism causing endocrine diseases, nephrotic syndrome, chronic liver disease, genetic hyperlipoproteinemias, and mastocytomas (Mast cells look much like basophils).
Platelet Count (PLT or Thrombocyte count): Platelets are cells that plug up holes in blood vessels and prevent bleeding. This test measures the number of platelets in a drop (microliter) of blood. Normal values range from 150,000 to 400,000 platelets per microliter. A count below 50,000 can result in spontaneous bleeding; below 5,000, patients are at risk of severe life-threatening bleeding.
Platelet Count Too High (Thrombosis): Rule out bleeding, cigarette smoking, excess production by the bone marrow, strenuous activity, myeloproliferative disorders, infections, inflammation, cancers, and when the spleen has been removed.
Platelet Count Too Low (Thrombocytopenia): Rule out premature destruction states such as immune-mediated thrombocytopenia, acute blood loss, drug effects (such as heparin), infections with sepsis, entrapment of platelets in an enlarged spleen, or bone marrow failure from diseases such as myelofibrosis or leukemia. Platelet counts decrease just before menstruation. If there are not enough platelets in your blood, you may notice signs of bleeding such as nosebleeds, easy bruising, prolonged bleeding from a cut, black or bloody stools, brown or red urine, or tiny pinpoint sized red or purple spots on your skin, under your nails or in your gums (petechial hemorrhage). Low platelets also can occur from clumping of the platelets in a lavender-top tube. You may need to repeat the test with a green top tube in th case.
RBC (Red Blood Count)
Hemoglobin (Hgb): Hemoglobin is the amount of oxygen carrying protein contained within the red blood cells.
Hemoglobin Too High: Rule out lung disease, living at high altitude, excessive bone marrow production of blood cells, kidney tumors, hepatomas (liver tumors), uterine leiomyomas, cerebellar hemangioblastomas, and sickle cell anemia
Hemoglobin Too Low: Rule out anemia due to nutritional deficiencies, blood loss, destruction of blood cells internally, or failure to produce blood in the bone marrow.Hematocrit (Hct, Packed Cell Volume or PCV): The hematocrit is the percentage of the blood volume occupied by red blood cells. Men have a slightly higher hematocrit percentages than women because women lose a bit of blood each month during their menstrual cycle.
Hematocrit Too High: Rule out smoking (due to too much carbon dioxide exposure), high altitude, chronic lung disease, and newborn syndrome.
Hematocrit Too Low: Rule out anemia due to nutritional deficiencies, blood loss, and destruction of blood cells internally, or failure to produce blood in the bone marrow.MCH (Mean Corpuscular Hemoglobin or Mean Corpuscular Volume (MCV) - This test helps diagnose the type of anemia.
MCH Too High: Rule out B12 deficiency, folate deficiency, ineffective production in the bone marrow, or recent blood loss with replacement by newer (and larger) reticulocytic cells from the bone marrow, and in vitro or in vivo hemolysis.
MCH Too Low: Rule out iron deficiency,MCHC (Mean Corpuscular Hemoglobin Content or concentration) denotes the volume and character of the hemoglobin and is the most accurate of the red cell indices.
MCHC Too High: Rule out spherocytosis (the cells are old and not being replaced as often), and in vitro or in vivo hemolysis.
MCHC Too Low: Rule out reticulocytes (too many young red cells), and iron deficiency.RDW (Red cell Distribution Width) This test measures the different sizes and shapes of the red cell. RDW is important because the more surface area the red cell has, the better it can hook onto and transport oxygen through the system.
RDW and MCV both Too High: Rule out liver disease, hemolytic anemia, Vitamin B12 deficiency, folic acid deficiency.
RDW Too High, but MCV Too Low: Rule out iron deficiency anemia, thalessemia intermedia (defective hemoglobin), fragmented cells.
RDW Too High, but MCV Normal: Rule out low Vitamin B12 or folic acid, iron deficiency anemia (early stages)
RDW Too Low: Rule out macrocytic anemia (red cells are too large), microcytic anemia (red cells too small). When the cells are all the same size, the RDW level will be low.
Note: One simple way to tell if you are anemic is to look at your cheeks and chin in the mirror. If they look like they have a blotchy tan, you are anemic and it will show up on a test within two weeks. My recommendation is to take about 3/4 tea. blackstrap molasses every day for a couple of months. When the anemia is gone, the tan will be too.
Blood Gasses: Blood gasses measure how much influence oxygen, carbon dioxide and hydrogen ion concentration (pH) has on our body. This sample has to be taken from an artery to accurately measure the oxygen content. The other blood samples are taken from veins and both pH and CO2 can be measured using venous blood. Blood gasses should be evaluated immediately.
Oxygen (PO2): The total oxygen concentration depends on total hemoglobin, oxygen-carrying capability of hemoglobin, body temperature, blood pH, certain blood enzymes and PO2 itself.
Oxygen Too High: Rule out gasses with high oxygen content (oxygen cages and anesthetic machines).
Oxygen Too Low (Hypoxia): Rule out respiratory disorders, heart shunts, or brain damage.
Carbon Dioxide (CO2) reflects the acid status of the blood and is a measure of the exchange of oxygen between the alveoli of the lungs.
Carbon Dioxide Too High: Rule out increased ventilation.
Carbon Dioxide Too Low: Rule out decreased ventilation, increased acidity from uncontrolled diabetes, kidney disease, heart shunts, and metabolic disorders.
Bicarbonate (HCO3-): Bicarbonate is maintained in health by conservation and production by the renal tubules, so if there is kidney disease of some kind, the values may be abnormal.
Cardiac Risk Factors
C Reactive Protein (CRP): This is a marker for inflammation.
C Reactive Protein Too High: Rule out inflammation in response to infection, vascular disease, heart attacks or strokes.
Homocysteine: Homocysteine is an amino acid that is normally found in small amounts in the blood. Higher levels are associated with increased risk of heart attack and other vascular diseases. Men tend to have higher levels.
Homocysteine Too High: Rule out folic acid deficiency, Vitamin B12 deficiency, heredity, aging, kidney disease, and certain medications. Lipoprotein or Lp: Lipoproteins are a combination of water-soluble proteins containing cholesterol and triglycerides and are present in the blood. The lipoproteins in this test break the lipoprotein down into its alpha or beta forms and determines the volumes of each. (Also see Cholesterol above).
Lipoproteins are also contained in the cholesterols high-density (HDL), low density (LDL), and very low density (VLDL) lipoproteins which are all factors in heart disease and cholesterol levels. These have been discussed under their individual cholesterol categories above.
Too High: Rule out premature coronary heart disease (CHD) and the genetic link to heart disease. Persons with diabetes and a high Lp level appear to have increased risk of asymptomatic coronary disease.
Thyroid Tests:To evaluate the thyroid your doctor will take blood to run a Thyroid Function Blood Panel, which will include many of the tests below depending on the doctor's education and the tests available at the laboratory. It is important to understand each test because there is a lot of confusion among doctors, nurses, lab technicians, and patients as to which test is which. In particular, the "Total T3", "Free T3" and "T3 Uptake tests" are very confusing, and are not the same test.
There ARE other options besides medications. For example, cholesterol. It can be abnormal for a variety of reasons, but it is often repaired so easily with natural products such as Chitosan.
Because I saw a need for this information, I sat down and compiled this handout. It took me three solid weeks to do it. I hope you get some useful information from it, and that you think about making an appointment with myself when it comes to deciding upon which option you will choose on your path to wellness.
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