CHOLESTEROL
Cholesterol is needed for every cell of our body, used in the structure of cell membranes,
synthesis of bile acids and steroid hormones, but the modern diet is killing us with heart disease due
to too much! Google: ASCVD Risk estimator, or:
The cholesterol numbers can be interpreted as follows: the
total cholesterol should be
under 200; the
HDL is called the good cholesterol and that should be over 45. More HDL means
better protection to the heart. That can be increased through exercise: usually cardiovascular exercise
at least three or four times a week for at least half an hour a day. In the old days they used to
compare the total cholesterol as a ratio to the HDL and any number of total cholesterol that was less
than five times the HDL was considered okay. Now we look at the
LDL (called the bad cholesterol)
as the most important risk factor and LDL should be under 130 at least. The
triglyceride is a
rough measure of the fatty content in the bloodstream and that can be reduced by less sugar, fried foods
and less meat. Excess alcohol intake can elevate triglyceride as well. The number should generally be
under 200.
Non-HDL cholesterol is a number to estimate heart risk just like LDL and is used
instead of LDL when the LDL is too high (from high triglyceride) to calculate accurately.
HDL Cholesterol
High Density Lipoproteins (HDL) in high levels have shown to provide a
protective effect against coronary heart disease. It is sometimes referred to as the good cholesterol.
Triglycerides
Triglycerides comprise the largest portion of fat in the blood. In higher
elevations it can be an indication of diabetes, acute alcoholism, liver disease or renal failure.
Triglycerides may also be elevated in non-fasting samples.
LDL Cholesterol
Low Density Lipoproteins (LDL) in elevated levels can be related to coronary
heart disease. It is also referred to as the bad cholesterol.
Glucose
This test measures blood sugar levels. This test is very sensitive to food intake and
requires a short period of fasting in order to reflect an accurate representation of blood sugar levels.
Since we don't have everyone fast, a level up to 140 might indicate a recent drink or snack, but would
need to be rechecked sometime in the near future.
UREA NITROGEN (BUN)
Blood Urea Nitrogen (BUN) is an end product of protein metabolism, which is
cleared by the kidneys. Elevated levels may be an indication of kidney disorders or diuretics.
Creatinine
Creatinine is a by-product of muscle tissue metabolism. Elevations might suggest
kidney or vascular diseases. High protein diets may cause mild elevations. Body builders may also have
more due to more muscle mass (or supplements)
eGFREstimated
Glomerular Filtration Rate provides a calculated measurement of the filtering
capacity of the kidneys. It is usually accepted as the best overall index of kidney function in both
healthy and diseased individuals
BUN/Creatinine ratio
Not really much usefulness in this calculated value
SODIUM
Sodium is part of your internal fluid balance with losses from sweating or water pills.
The most common cause of a low value is actually a normal amount of sodium
in the body but with
too much
dilution due to a failure of the kidney removing water from the body.
POTASSIUM
Potassium is also part of the fluid balance more concentrated inside the cells of
your body. An abnormal value is frequently an indicator of imbalance in the pH of the body for instance
after vomiting a lot of acid, or again losses with water pills.
CHLORIDE
After excessive vomiting chloride will be abnormal as it is part of the fluid balance.
Diuretics can alter this as well.
CARBON DIOXIDE
Acid base balance is regulated by both the lungs and the kidneys and carbon
dioxide is dissolved in the blood (bicarb). Just hyperventilating for the blood test can make this
abnormal.
CALCIUM
A tiny amount of your whole body supply of calcium is found in the blood and here
measured. Slightly elevated values are common but if raised more or for longer duration it may indicated
a problem with your body's ability to regulate it. PTH is a test on the parathyroid glands that might be
done if the calcium is too high.
PROTEIN, TOTAL
Proper nutrition keeps this value up. Too high a number could indicate
dehydration or chronic inflammation. Extremely low values may be associated with malnutrition or
peripheral edema.
Albumin
Albumin is one part of a group of serum proteins and a component of total serum
protein. Low values may be a result of hepatic (liver) or renal (kidney) disorders. Higher values may
indicate dehydration.
Globulin
Globulin is a component of total serum protein. Abnormal levels have been found in
individuals with immune disorders, infections and other diseases.
RATIO
doesn't mean much
Bilirubin Total
Total Bilirubin is a by-product of the-breakdown of red blood cells made into a
water-soluble form in the liver. Elevations can indicate chronic liver disease, gall bladder disease, or
anemia.
Alkaline Phosphatase
Alkaline Phosphatase is an enzyme found primarily in the liver and bones.
These levels are usually higher in pregnant women and children due to its role in the bone making
process. Elevated levels may be an indication of bone, kidney or liver disorders.
AST
Aspartate Aminotransferase (AST) is an enzyme found in high concentration in heart muscle,
liver cells, skeletal muscle cells and to a lesser degree in other tissues. Elevated levels of AST can
indicate muscle trauma, heart damage or most commonly damage to the liver. The epidemic of obesity has
caused unprecedented numbers of patients with abnormal liver enzymes just from fat clogging up the liver
causing poor liver function. Such values should not be much over 100--- if they are higher we may need
to check for hepatitis (usually viral). Some patients drink and don't admit it and this value is high
from alcohol damage to the liver.
ALT
Alanine Aminotransferase (ALT) is an enzyme involved in the metabolism of the amino acid
alanine. ALT is found in a number of tissues but in higher concentration in the liver. Elevated levels
can be due to certain medications (especially cholesterol medications) or extensive exercise, but can
also be a sign of liver disorders (see AST).
TSH
Thyrotropin (TSH) promotes the growth of the thyroid gland in the neck and stimulates it to
produce more thyroid hormone (T4). This is used as a screening test as well thyroid replacement
monitoring test. The value is HIGH in hypothyroidism and LOW in hyperthyroidism (inverse relationship).
If you are on synthroid or L-thyroxine and your level is high you need a higher dose and conversely if
it is low you need a lower dose.
T4- thyroxine, also called 3,5,3,5'- tetraiodothyronine
The thyroid gland makes this hormone
which is exactly what we give people when they have hypothyroidism. It actually can't do much until the
peripheral tissues alter it into T3. But only one in a million (approx) people have a problem making T4
into T3.
T3 triiodothyronine
This is the thyroid hormone that does the job of regulating our metabolism.
It would seem like this would help us lose weight but it doesn't. The body's carburetor (the thyroid
gland) knows how to give the body more of this hormone in times of stress and growth.
Glycohemoglobin A1C
Glycosylated hemoglobin (HBA1C) is a time averaged indicator of blood
glucose levels over the previous two to three months. We can tell roughly how good diabetes is being
controlled by checking this number once or twice a year. It is not affected by fasting. It snitches on
you!
PSA (Prostate Specific Antigen)
Prostate Specific Antigen (PSA) can indicate the condition of
the prostate gland in men. Elevations may indicate a risk for prostate cancer, however other benign
factors have also been known to elevate PSA values. There is controversy over even testing this number,
but I prefer to check it once yearly in men over 50 or younger if your dad had prostate cancer. In the
old days (20 years ago) we routinely left men alone as they got closer to 60 yrs old even if their PSA
got to 8 in the absence of symptoms (lots of urinating in the middle of the night, incomplete emptying
of the bladder causing you to go again just after you finished urinating). On the opposite end of the
spectrum a recent Swedish study found more cancer in those with PSA's over 2.5. Another call to concern
is a number rising faster than ½ a unit a year. If you get a high number we should skip all caffeine and
chocolate, alcohol and rest from vigorous exercise, bicycling and intercourse for a week and recheck it.
We will discuss it more if it stays high. Medicines finasteride and doxazasin can shrink prostates.
WHITE BLOOD CELL COUNT
This is an overall count on the cells that fight infections High means
the body is fighting something unless really high in leukemia. Some people always run low. Really low
may be a problem requiring a bone marrow examination.
RED BLOOD CELL COUNT
This is the number of red cells per unit volume
HEMOGLOBIN
This is the amount of oxygen-carrying capacity through the protein by this name.
HEMATOCRIT
This is how tight we can pack the cells. While training we had a centrifuge and took
a little capillary tube of blood, packed some clay on the end of the tube and spun it and measured the %
just by comparing the percentage of the tube that was blood red vs clear serum.
MCV
Size of red blood cells which runs high in pernicious anemia (lack of B12 and folate) and
low in iron deficiency as well as some hereditary conditions like thalassemia. Also high if you drink
too much alcohol.
MCH
Amount of hemoglobin in each cell (calculated)
MCHC
Amount of hemoglobin in cell as a concentration
RDW
The variability of red blood cell size. It is normally uniform, high values represent a
blood factory working extra vigorously as in blood loss or disease.
PLATELET COUNT
The clotting cells. This number can be all over the board and is frequently
inaccurate. If it is low and you are bleeding we need to address it. Or if it is always low. Rarely we
will find it always high and may need to address that..
ABSOLUTE NEUTROPHILS
The while blood cells that fight infections either early in the disease or
if it is a bacteria.
ABSOLUTE LYMPHOCYTES
The while blood cells that fight viral diseases mostly.
ABSOLUTE MONOCYTES
This is high in mono and sometimes other minor conditions.
ABSOLUTE EOSINOPHILS
This is high with excessive allergic tendencies or sometimes just for a
spell after exposure to something the body is allergic to.
ABSOLUTE BASOPHILS
The while blood cells that fight parasites and sometimes elevated in
allergies.
NEUTROPHILS %
LYMPHOCYTES %
MONOCYTES %
EOSINOPHILS
BASOPHILS %
These numbers just give the cell type as a percentage of all the white cells. Most
docs would only look at the exact numbers (above) when something is out of range.
