BLOODCHEMISTRY

C r e a t i n i n e M a l e :
0 . 5 4 1 . 4 0 Fem
ale: 0.54-1.25 mg/dl1.0 mg/dl
interpretation:
normal.
Analysis:
A s t h e k i d n e y s become impaired
for a n y r e a s o n , t h e c r e a t i n i n e l e v e l i n t h e b l o o d w i l l r i s e d u
e
t o
p o o r
c l e a r a n c e b y t h e kidneys.
Abnormallyh i g h
l e v e l s
o f
creatinine thus
warno f
p o s s i b l e m a l f u n c t i o n o r f a i l u r
e
o f
t h e kidneys.
P o t a s s i u m P l a s m a :
3 . 5 4 .
6 mmol/LS e r u m : 3 . 6 - 5 . 4 mmol/L4.0 mmol/L
nterpretation:
normal.
Analysis:
C o n t r o l l e d v e r y c a r e f u l l y b y t h e kidneys, potassiumi s a n
electrolytef o u n d
p r i m a r i l y inside cells. Its roleis to
maintain water b a l a n c e i n s i d e the cells and to
helpin the transmissionof nerve impulses. Itis very important
for t h e
p r o p e r
functioning of then e r v e
s
a n d muscles, particularlythe heart. Any
valueo u t s i d e
t h e e x p e c t e d r a n g e , high or
low, requiresimmediate medical
evaluation.A l o w p o t a s s i u m l e v e l c a n c a u s e m u s c l e w e a k n e
s s and heart problems.A h i g h p o t a s s i u m l e ve l c a n b e f o u n d in kidney
disease or in over ingestion of potassiumsupplements
S o d i u m 1 3 4 1 4 8
m m o l / L
1 3 9
m m o l / L
interpretation:
normal.
Analysis:
A n e l e c t r o l y t e r e g u l a t e d b y t h e kidneys and
adrenalg l a n d s .
T h i s e l e m e n t p l a y s a n important role in
thewater/salt balance iny o u r b o d y . T h e r e a r e
n u m e r o u s causes
of high
andl o w s o d i u m l e v e l s , b u t
t h e
m o s t common causes of l o
w s o d i u m a r e diuretic usage, ande x c e s s i v e w a t e r i n t a k e i
n p a t i e n t s w i t h h e a r t o r l i v e r d i s e a s e . A h i g h level can be
causedb y a n e x c e s s i v e i n t a k e o f s a l t o r even an insufficien
tintake of water.

HEMATOLOGY
H e m a t o c r i t M a l e :
4 2 v o l . percentF e m a l e : 3 6 - 4 6 vol. percent40
interpretation:
normal.
Analysis:
T h e h e m a t o c r i t o r packed cell volumei s a f a s t
e r m i n e t h e p e r c e n t a g e o f

w a y

t o d e t

R B C s
i n
t h e p l a s m a .
I f
t h e hematocriti n c r e a
sed it mayr e s u l t
t o : Polycythemia,D e h y d r a t i o
n andB u r n s
w h i l e
i f
d e c r e a s e d i t m a y result to: Blood
loss,O v e r h y d r a t i o n , D i e t a r y d e f i c i e n c y and Anemia.
H e m o g l o b i n M a l e :
1 1 . 5 1 6 Female:
1 4 g m s percent13.4
interpretation:
normal.
Analysis:
H e m o g l o b i n a l s o p l a ys a n i m p o r t a n t r o l e i n m a i n t a i n i n g the shape of
the
redb l o o d
c e l l s . Abnormalhemoglobins t r u c t u r e c a n
, t h e r e f o r e , d i s r u p t t h e s h a p e o f r e d b l o o d c e l l s a n d im
pede its functionand its flow throughblood vessels.
W h i t e b l o o d c e l l s 5 , 0 0 0 - 1 0 , 0 0 0 cumm8,800
interpretation:
normal.
Analysis:
A l o w w h i t e b l o o d c e l l c o u n t i s c a l l e d leukopeniaa n d i t cause viral
infectionw h i l e h i g h w h i t e b l o o d c e l l c o u n t i s termedleukocytosis a n d
i t
c a u s e bacterial infection.
DIFFERENTIAL
S
e
g
m
e
n
t
e
r
s
6
0
7
0
%
8
6
interpretation:
above the normal
Analysis:
E l e v a t i o n
o f
s e g m e n t e r s m a y indicates presenceof i
nfection; meanst h a t m a n y b a n d (immature)cells arepresent as the
bodyfights infection.
L
3

y
5

m
%

p
1

h
0

interpretation:
below the normal
Analysis:
A l o w l y m p h o c y t e count indicates thatt h e
b o d y ' s
r e s i s t a n c e t o f i g h t infection has beens u b s t a n t i a l l y l o s t a n d
o
n e
m a y b e c o m e
m o r e s u s c e p t i b l e t o ce
r t a i n t y p e s o f i n f e c t i o n , n a m e l y cancer a n d t u m o r.As lymphocyte
cellsm a k e u p f i f t e e n t o forty percent of thet o t a l w h i t e b l o o d cells that
circulate int h e b l o o d s t r e a m , a low count can causedamage to organs.

P l a t e l e t c o u n t 1 5 0 , 0 0 0 - 4 5 0 , 0 0 0 / mm3211,000/
mm3
interpretation:
normal
Analysis:
Platelets are cells inthe Blood which aren e c e s s a r y t o h e l p Blood clot. A
normalp l a t e l e t c o u n t i s between 150 to
440thousand per cubicm i l l i m e t e r . L o w p l a t e l e t c o u n t s a r e calledthrom
bocytopeniaw h i c h
c a n
b e c a u s e d b y s o m e drugs.

Result and Interpretation of the different BLOOD TESTSLIVERTotal Protein

(TP) - A rough measure of the total amount of serum protein in your body. Protein
measurements can reflect not onlyliver disease, but nutritional state, kidney disease,
and many other conditions as well. If the total protein result is abnormal, further
testsmust be performed to identify which protein fraction, and then which specific
protein, is abnormal.
Albumin
- The most abundant protein found in Blood plasma, representing 40% to 66% of the
total protein in your body. Albuminkeeps water inside your Blood vessels.
Reduced levels of albumin may reflect a variety of conditions, including primary liver
disease,increased breakdown of macromolecules resulting from tissue damage
or inflammation, malnutrition, malabsorption syndromes, andrenal diseases.
Globulin
- Globulins are a diverse group of proteins in the Blood that grouped together
represent the second most common proteins(after albumin) in the Bloodstream.
Globulin is actually made up of about 60 different important proteins and is one of the
componentsthat help to fight infections. Some of the proteins in this group play

an important role in Blood clotting. An elevation in the level of serumglobulin can

indicate the presence of cirrhosis of the liver.
ALT/SGPT
(Alanine Aminotransferase) - Found mainly in the liver, the activity of this enzyme
is measured in Blood plasma. Damagefrom alcohol, strenuous exercise, some
medications and a number of diseases can cause high test values. Elevated levels of
thisenzyme can be an indication of viral hepatitis and other forms of liver disease.
AST/SGOT
Aspartate Aminotransferase - An increase of aspartate aminotransferase (AST, formerly
referred to as "SGOT") is found inany condition involving necrosis of hepatocytes,
myocardial cells, or skeletal muscle cells. As in AST/SGPT, damage from
alcohol,strenuous exercise, some medications and a number of diseases can cause
high test values. Decreased serum AST is of no knownclinical significance.
Bilirubin, Total
- The coloring agent in the Blood that makes the plasma (serum) part of your Blood
yellow. When the bilirubin level isvery high for an extended period of time, the whites of
your eyes and even your skin may become yellow (jaundice). Bilirubin comesfrom the
breakdown of old red cells in the Blood. Total bilirubin is increased most commonly in
liver disease (hepatitis, malignancy,advanced cirrhosis) and due to obstruction of the
biliary system (gall stones, pancreatic cancer). Severe haemolytic anaemia
can causemoderate increases which are almost entirely made up of the unconjugated
fraction. Moderate to marked hyperbilirubinaemia is seen insome neonates especially if
premature and can be caused by inborn errors of bilirubin metabolism or transport is a
small number of cases.
Bilirubin, Direct
- A specific form of bilirubin (conjugated) that is formed in the liver and excreted in bile.
Under normal conditions verylittle of this form of bilirubin is found in the Blood. In liver
disease, however, this form of bilirubin enters the Bloodstream so that even aslightly
high level may indicate a problem with the liver cells, an obstruction of the bile ducts, or
impairment of liver cell function.
Alkaline Phosphatase
- An enzyme found in all body tissue, but primarily in bones, bile ducts and in the liver. A
high level may indicatebone, liver, or bile duct disease. Some drugs may also cause
increased levels. Expected values are higher for those who are growing(children and
pregnant women) or when damage to bones or liver has occurred or with a gallstone
condition. Low values are probablynot significant.

KIDNEY
/ ElectrolytesBUN
(Blood Urea Nitrogen) - A waste product, derived from protein breakdown, produced in
the liver and excreted by way of thekidneys. High values may mean that the kidneys are
not working as well as they should. BUN is also elevated by Blood loss,dehydration,
high protein diets and/or strenuous exercise which may temporarily and artificially raise
levels. A low BUN level may be theresult of liver disease, a low protein diet, pregnancy,

or drinking an extreme amount of water. Normal BUN levels should be betweeneight

and 23 milligrams per deciliter of Blood (mg/dL); normal creatinine levels should
be between 0.7 and 1.3 mg/dL.
Creatinine
- A waste product largely from muscle metabolism (breakdown). Concentration of
creatinine in the Blood depends upon theamount of muscle that you have and the ability
of your kidneys to excrete creatinine. High values, especially with high BUN levels,
mayindicate problems with the kidneys. Because of its insensitivity in detecting
early renal failure, the creatinine clearance is significantlyreduced before any rise in
serum creatinine occurs. The renal impairment may be due to intrinsic renal lesions,
decreased perfusion of the kidney, or obstruction of the lower urinary tract. Low values
are generally not considered significant.
BUN/Creatinine Ratio
- By comparing the BUN level in the Blood to the creatinine level, your physician
can determine if a high BUNlevel is caused by kidney disease, dehydration, or by
gastrointestinal bleeding.
Calcium
- Controlled in the Blood by the parathyroid glands and the kidneys, calcium is one of
the most important elements in thebody. Virtually all of the calcium in your body is found
in bone (99%). That other 1% is very important for proper Blood clotting, nerve,and cell
and enzyme activity. The parathyroid gland is the main regulator of calcium in the
body. An elevated calcium can be due tomedication, inherited disorders of calcium
handling in the kidneys, bone disease, or excess parathyroid gland activity or vitamin D.
Lowcalcium can be due to malnutrition, drugs and certain metabolic disorders and
should be re-evaluated.
Sodium
- An electrolyte regulated by the kidneys and adrenal glands. This element plays an
important role in the water/salt balance inyour body. There are numerous causes of high
and low sodium levels, but the most common causes of low sodium are
diuretic usage,and excessive water intake in patients with heart or liver disease. A high
level can be caused by an excessive intake of salt or even aninsufficient intake of water.
Sodium levels should be between 136 and 144 millimoles per liter of Blood (mmol/L).
Potassium
- Controlled very carefully by the kidneys, potassium is an electrolyte found primarily
inside cells. Its role is to maintainwater balance inside the cells and to help in the
transmission of nerve impulses. It is very important for the proper functioning of
thenerves and muscles, particularly the heart. Any value outside the expected range,
high or low, requires immediate medical evaluation.This is especially important if you
are taking a diuretic (water pill) or heart pill (Digitalis, Lanoxin, etc.) A low potassium
level can causemuscle weakness and heart problems. A high potassium level can be
found in kidney disease or in over ingestion of potassiumsupplements. Potassium levels
should be between 3.6 and 5.1 mmol/L.
Chloride
- Important to the function of nerves, muscles, and cells. Chloride is an electrolyte
regulated by the kidneys and adrenalglands. It is usually associated with a high or low
level of sodium or potassium. Increase in serum chloride is seen in dehydration,

renaltubular acidosis, acute renal failure, diabetes insipidus, prolonged diarrhea, and
some other rare conditions or medications. Somedrugs cause decreased chloride
levels. Levels should be between 99 and 108 mmol/L.
CO2
- Reflects the acid status of your Blood. Abnormally high or low levels may indicate
severe problems if you have had prolongedvomiting, are on lots of fluid pills or if
you have out of control diabetes. Normal values for CO2 in Blood range from 20 to
29milliequivalents per liter (mEq/L).

HEART
Total Cholesterol
- Cholesterol in itself is not all bad, in fact, our bodies need a certain amount of this
substance tofunction properly. When the level gets too high, however, serious problems
can result. Levels of 200 or more areconsidered too high for good health. Levels of 240
and above are considered very high risk, and may indicate the need for cholesterol
lowering medication. A low fat diet and regular exercise are recommended. As the level
of Blood cholesterolincreases, so does the possibility of plugging the arteries due to
cholesterol plaque build-up. Such a disease process iscalled "hardening of the arteries"
or atherosclerosis. When the arteries feeding the heart become plugged, a heart
attackmay occur. If the arteries that go to the brain are affected, then the result is a
stroke.
HDL Cholesterol
- (High Density Lipoprotein) A good cholesterol as it protects against heart disease
by helping removeexcess cholesterol deposited in the arteries. High levels seem to be
associated with low incidence of coronary heartdisease. Latest guidelines recommend a
HDL >45. If your level is below 30, it can signal a significant risk of early heartdisease.
Tryglycerides
- Fat carried in the Blood. Normal triglycerides should be between 50 and 200 mg/dL.
Triglyceride levelsover 150 mg/dl may be associated with problems other than heart
disease. If levels exceed 500 mg/dL, the situation isconsidered acute. The ways
to lower triglycerides are: 1) weight reduction, if overweight; 2) reduce animal fats in the
diet:eat more fish; 3) take certain medications that your physician can prescribe such as
Lopid, Tricor or Niacin; 4) get regular aerobic exercise; and, 5) decrease alcohol and
sugar consumption. Alcohol and sugar are not fats, but the body canconvert them into
fats, then dump those fats into your Blood stream. High triglycerides are also associated
withpancreatitis.
LDL Cholesterol
- (Low Density Lipoprotein) Considered "bad cholesterol" because cholesterol deposits
form in thearteries when LDL levels are high. An LDL level of less than 130 is
recommended; 100 is ideal; values greater than 160are considered high risk and should
be followed up by your physician. Those persons who have established coronary
or vascular disease or Diabetes may be instructed by their doctor to get their LDL
Cholesterol well below 100. You shouldask your doctor which LDL target he or
she wants for you.
VLDL Cholesterol

- (Very Low Density Lipoprotein) A type of cholesterol found in the Blood that is
considered to be themost dangerous form of lipoprotein. They carry the least amount of
protein and the most amount of fat. They also stick toartery walls and contribute to
plaque build-up.
CK/CPK
- An enzyme which is very useful for diagnosing diseases of the heart and skeletal
muscle. This enzyme is thefirst to be elevated after a heart attack (three to four hours).
If CPK is high in the absence of heart muscle injury, this is astrong indication of skeletal
muscle disease. Sometimes this is checked to monitor possible muscle irritation
fromcholesterol lowering drugs.
LDH
- The enzyme present in all human cells. 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. If all values except LDH arewithin expected ranges, it is
probably a processing error and does not require further evaluation.
BONES
Calcium
- Increased levels of plasma calcium may indicate the presence of malignant disease
or hyperparathyroidism. Less commonly, it could reflect thyrotoxicosis, vitamin D intoxication, the use
of thiazidediuretics, sarcoidosis, and other disorders. Reduced levels of calcium may reflect vitamin D
deficiency, renaldisease, hypoparathyroidism, magnesium deficiency and other disorders.
Alkaline Phosphatase
(ALP) - Alkaline phosphatases are a family of enzymes that are present throughout thebody, but the
most important places are in bone, liver and bile ducts,. Elevated levels of ALP are associatedwith
liver and bile duct disorders and bone diseases. Growing children, because of bone growth, normally
havehigher levels than adults. Low values are not generally considered significant.
METABOLISM
(Pancreas)
Glucose
- Glucose is a chief source of energy for all living organisms. Elevated Blood glucose
levels(hyperglycemia), in someone who has fasted for 12 hours, may be an indication of diabetes
mellitus if thefasting level is above 124. Lower-than-normal Blood glucose levels (hypoglycemia) may
mean too muchinsulin in your Blood, or could be caused in a variety of other ways, often transiently,
and must be carefullyexamined under specific clinical conditions before expanding the diagnosis.
MINERALSIron
- The body must have iron to make hemoglobin and to help transfer oxygen to the muscles. If the
humanbody is low in iron, all body cells, particularly muscles in adults, do not function properly.
Conversely, too muchiron can cause injury to the heart, pancreas, joints, and genital parts in both
males and females. Excess iron isfound in the hereditary Blood disease called hemochromatosis.
Ferritin
- Measured to assess the amount of iron, important for red Blood cell production, in the body.
Ferritinis useful for early detection of iron deficiency. Ferritin is the major iron storage protein. The
serum ferritin levelis directly proportional to the amount of iron stored in the body.
Magnesium
- Magnesium, a Blood salt, found primarily inside the cells, helps regulate energy production inthe
cells, and is necessary for nerve function. This test is not often ordered for adults.

Phosphorus
- Phosphorus is closely associated with calcium in bone development. Most of the phosphorus inthe
body is found in the bones. An adequate phosphorus level in the Blood is very important for muscle
andnerve function. Increased levels of plasma phosphate ion may indicate imminent renal
failure,hypoparathyroidism, acromegaly, excessive phosphate intake, and vitamin D intoxication.
Sharply decreased levels of plasma phosphate may reflect starvation or malnutrition, vitamin D
deficiency, primaryhyperparathyroidism, magnesium deficiency, and diabetic ketoacidosis.
HEMATOLOGY TESTS
These tests are the most commonly used Blood test tool to measure the number and amount of
formed elements in theBlood. Formed elements include
red Blood cells
,
white Blood cells
, and
platelets
.
COMPLETE BLOOD COUNT
(CBC)

Red Blood Cells

(RBC) - Also called erythrocytes, RBCs are responsible for delivering oxygenthroughout the body.
There are between 3.6 to 6.1 million red Blood cells in a single cubic millimeter of Blood. Anemia, a
condition generally defined as a decreased number of red Blood cells, can becaused by certain antiHIV drugs or be a sign of an underlying illness. Women of child-bearing agemay also experience
anemia as a result of Blood loss from their menstrual periods. One of the mostcommon physical
symptoms of anemia is fatigue.
Hemoglobin
(HGB) - A protein which enables the RBCs to distribute oxygen throughout the body. Ahemoglobin
test is done when a person is ill or during a general physical examination. Good healthrequires an
adequate amount of hemoglobin. The amount of oxygen in the body tissues depends onhow much
hemoglobin is in the red cells. Without enough hemoglobin, the tissues lack oxygen, andthe heart
and lungs must work harder to try to compensate. If the test indicates a "less than" or "greater than"
normal amount of hemoglobin, the cause of the decrease or increase must bediscovered. A low
hemoglobin usually means the person has anemia. Anemia results from conditionsthat decrease the
number or size of red cells, such as excessive bleeding, a dietary deficiency,destruction of cells
because of a transfusion reaction or mechanical heart valve, or an abnormallyformed hemoglobin. A
high hemoglobin may be caused by polycythemia vera, a disease in which toomany red Blood cells
are made. Hemoglobin levels also help determine if a person needs a Bloodtransfusion. Normal
hemoglobin levels range from 12 to 16 grams per deciliter (g/dL) of Blood.Usually a person's
hemoglobin must be below eight gm/dl before a transfusion is considered.
Hematocrit
- Hematocrit measures the percentage of Blood that is occupied by RBCs. Generallyspeaking, red
Blood cells should make up 40% to 52% of the total Blood volume in men and 35% to46% in
women. The hematocrit is a compound measure of red Blood cell number and size.Decreased
hematocrit indicatesanemia, such as that caused by iron deficiency or other deficiencies.Further
testing may be necessary to determine the exact cause of the anemia.

Other conditions that can result in a low hematocrit includevitamin or mineral deficiencies,
recentbleeding,cirrhosisof the liver, and malignancies.The most common cause of increased
hematocrit isdehydration, and with adequate fluid intake, thehematocrit returns to normal. However, it
may reflect a condition called
polycythemia vera
that is,when a person has more than the normal number of red blood cells. This can be due to a
problemwith thebone marrowor, more commonly, as compensation for inadequate lung function (the
bonemarrow manufactures more red blood cells in order to carry enough oxygen throughout your
body).Anytime a hematocrit is persistently high, the cause should be determined in consultation with
adoctor.With regard to transfusions, this is normally not considered for otherwise healthy persons as
long asthe hemoglobin level is above 8 grams per deciliter or the hematocrit is above
24%.Pregnancy usually causes slightly decreased hematocrit values due to extra fluid in the blood.
Living at highaltitudes causes increased hematocrit valuesthis is your bodys response to the
decreased oxygenavailable at these heights.
Calculated Results
(Indices) - The values that measure hemoglobin, hematocrit, and plateletcomponents found in red
Blood cells. There are five indices:
MCV
- (Mean Corpuscular Volume) - Measures the average size of red Blood cells. Range: 80to 95
femtoliter;
MCH
(Mean Corpuscular Hemoglobin) - Reflects the average weight of hemoglobin found inthe red Blood
cell. Range: 27 to 31 pg/cell;
MCHC
(Mean Corpuscular Hemoglobin Concentration) - reflects the average amount of hemoglobin in the
red Blood cell. Range: 32 to 36 gm/dl;
MPV
(Mean Platelet Volume) - Reflects the average volume of platelets. Range: 7.4 - 10.4 fL;and,
RDW
(Red Blood Cell Distribution Width) - Reflects the distribution of the size of the red Bloodcell
population. Range: 2 to 8% of white Blood cells.
WHITE BLOOD CELLS
DIFFERENTIALNeutrophils
- Neutrophilia (>25,000/L) brings up the problem of hematologic malignancy
(leukemia,myelofibrosis) versus reactive leukocytosis, including "leukemoid reactions." Laboratory
tests of this problem may include expert review of the peripheral smear, leukocyte alkaline
phosphatase, andcytogenetic analysis of peripheral Blood or marrow granulocytes. Neutropenia may
be found incertain infections, including typhoid fever, brucellosis, viral illnesses, rickettsioses, and
malaria. Other causes include aplastic anemia (see list of drugs above), aleukemic acute leukemias,
thyroiddisorders, hypopitituitarism, cirrhosis, and Chediak-Higashi syndrome.
Lymphocytes

- Lymphocytosis is seen in infectious mononucleosis, viral hepatitis, cytomegalovirusinfection, other

viral infections, pertussis, toxoplasmosis, brucellosis, TB, syphilis, lymphocyticleukemias, and lead,
carbon disulfide, tetrachloroethane, and arsenical poisonings. A maturelymphocyte count >7,000/L
in an individual over 50 years of age is highly suggestive of chroniclymphocytic leukemia (CLL).
Drugs increasing the lymphocyte count include aminosalicyclic acid,griseofulvin, haloperidol,
levodopa, niacinamide, phenytoin, and mephenytoin. Lymphopenia is acharacteristic indication of
AIDS. It is also seen in acute infections, Hodgkin's Disease, systemiclupus, renal failure,
carcinomatosis, and with administration of corticosteroids, lithium,mechlorethamine, methysergide,
niacin, and ionizing irradiation. Of all hematopoietic cellslymphocytes are the most sensitive to wholebody irradiation, and their count is the first to fall inradiation sickness.
Eosinophils
- Eosinophilia is seen in allergic disorders and invasive parasitoses. Other causesinclude pemphigus,
dermatitis herpetiformis, scarlet fever, acute rheumatic fever, variousmyeloproliferative neoplasms,
irradiation, polyarteritis nodosa, rheumatoid arthritis, sarcoidosis,tuberculosis, coccidioidomycosis,
smoking, idiopathically as an inherited trait, and in the resolutionphase of many acute infections.
Eosinopenia is seen in the early phase of acute insults, such asshock, major pyogenic infections,
trauma, surgery, etc. Drugs producing eosinopenia includecorticosteroids, epinephrine,
methysergide, niacin, niacinamide, and procainamide.
Basophils
- Basophilia, if absolute and of marked degree, is a great clue to the presence of myeloproliferative
disease as opposed to leukemoid reaction. Other causes of basophilia includeallergic reactions,
chickenpox, ulcerative colitis, myxedema, chronic hemolytic anemias, Hodgkin'sDisease, and status
post-splenectomy. Estrogens, antithyroid drugs, and desipramine may alsoincrease basophils.
PLATLETS
Platelets are cells in the Blood which are necessary to help Blood clot. A normal platelet count is
between 150 to 440 thousand per cubic millimeter. Low platelet counts are called
thrombocytopeniawhich can be caused by some drugs.
Other Hematological TestPancreatic Tests
Amylase and Lipase, enzymes produced by the pancreas to aid in the digestion of carbohydrates,
are strong indicators of pancreatic disease (pancreatitis) if they are elevated. Pancreatitis, if
notproperly dealt with, can cause serious nutritional problems and even death. Pancreatitis,
diagnosed early, ismost often reversible once revealed and treated. Amylase is also found in saliva,
and elevated Blood levels of amylase are sometimes due to leakage from the salivary glands.
Further tests can be done to distinguishbetween these two sources of amylase.
Serology TestSEROLOGY TESTS:
Unlike microbiological tests, which look for the presence of a disease causingmicroorganism,
serologic tests most often look for specific antibodies produced by the immune system inresponse to
specific disease causing microorganisms. Also unlike microbiology tests, serology tests are
veryuseful to determine if the patient has been exposed to an infection before they begin showing
signs of disease.
Syphilis Serology
STS or VDRL - Syphilis is a potentially fatal bacterial infection usually spread via sexualactivity (i.e.,
vaginal, or oral, or anal sex). If detected and treated early, usually during the first year of
infection,syphilis can be controlled. If left unchecked, it becomes much more difficult to treat and can
result in seriousdisease of the brain and death. It is generally recommended that those who are

sexually active be tested for syphilis antibodies at least annually. Serology testing can also be used to
determine if the infection hasresponded effectively to therapy.
Hepatitis B and Hepatitis C Serology
- Hepatitis B virus (HBV) andHepatitis Cvirus (HCV) can both causeliver problems. HBV is not
usually fatal, but can cause liver problems in a small percentage of those infected.HCV, on the other
hand, can cause serious liver disease in the majority of patients infected with the virus.
Mononeucleosis
- Infectious mononucleosis is a viral disease that affects certain Blood cells. It is caused bythe
Epstein-Barr virus (EBV), which is a member of the herpes virus family.
Epstein Barr
- This test is sometimes checked to see if prolonged fevers or fatigue are caused by this
difficultvirus. Antibodies are checked to see if there is signs of recent or past infections. Most people
developantibodies eventually, but if the early antibodies are present, it may give us a clue to a recent
infection causingsymptoms.
HIV Antibody Testing
- This test has remained one of the least expensive, most reliable methods of diagnosing HIV. HIV
antibody testing also allows patients to find out their status many years before they get sick, allowing
them to start medication to treat HIV. Results of this test cannot be given over the phone and
youmust sign a form explaining the HIV test before we can send it.
OTHER TESTS
There are some tests that do not easily fit into any of the other categories. We group them together
here.
Thyroid
- There are two often utilized types of thyroid hormones easily measurable in the Blood, thyroxine
(T4)and triiodothyronine (
T3
). For technical reasons, it is easier and less expensive to measure the TSH and thatusually tells us
what is wrong, if that is off we may also measure FreeT4 level, but T3 is usually not measuredon
screening tests.
Thyroid Stimulating Hormone (TSH)
- This protein hormone is secreted by the pituitary gland and regulatesthe thyroid gland. A high level
suggests your thyroid is underactive, and a low level suggests your thyroid isoveractive. This is
usually the test used to screen for high or low thyroid and monitor dosage of medicationssuchas
Synthroid, Levoxyl, Unithroid, etc.
T3 Uptake
or
Thyroid Uptake
- This test often causes confusion. This is NOT a thyroid test, rather a test onthe proteins that carry
thyroid around in your Blood stream. Moreover, a high test number may indicate a lowlevel of the
protein. The method of reporting varies from lab to lab. The test is to compute the free thyroxineindex.
Thyroxine
(
T4

) - This shows the total amount of the T4. High levels may be due to hyperthyroidism,
however technical artifact occurs when estrogen levels are higher from pregnancy, birth control pills
or estrogenreplacement therapy. A Free T4 (see below) can avoid this interference.
Free Thyroxine Index
(
FTI
or
T7
) - A mathematical computation allows the lab to estimate the free thyroxineindex from the T4 and T3
Uptake tests. The results tell us how much thyroid hormone is free in the Bloodstream to work on the
body. Unlike the T4 alone, it is not affected by estrogen levels.
Free T4
- This test directly measures the free T4 in the Blood rather than estimating it like the FTI. It is a
morereliable, but a little more expensive test. Some labs now do the Free T4 routinely rather than the
Total T4.
Total T3
- This test is usually ordered when thyroid disease is being evaluated. T3 is the stronger and
shorter lived version of thyroid hormone. Some people with high thyroid levels secrete more T3 than
T4. In these(overactive) hyperthyroid cases the T4 can be normal, the T3 high, and the TSH low. The
Total T3 reports thetotal amount of T3 in the Bloodstream, including T3 bound to carrier proteins plus
freely circulating T3.
Free T3
- This test measures the amount of thyroid hormone T3 that is "free" or not bound to carrier proteins.
Blood Sugar / Diabetes testsGlucose
- This is a measure of the sugar level in your Blood. High values are associated with eatingbefore the
test, and diabetes. The normal range for a fasting glucose is 60 to125 milligrams per deciliter of
Blood (mg/dL). According to ADA criteria, diabetes is diagnosed with a fasting plasmaglucose of 126
or more. A precursor, Impaired Fasting Glucose (IFG) is defined as reading of fastingglucose levels of
110 to 125. Sometimes a glucose tolerance test, which involves giving you a sugarydrink followed by
several Blood glucose tests, is necessary to properly sort out normal from IFG fromdiabetes.NOTE:
Variations in lab 'normals' exists, and Europeans tend to use a 'two hour after eating' definitionof
diabetes rather than a fasting glucose. Using the European standard tends to increase the number of
people who are classified as having diabetes.
Glycohemoglobin
(Hemoglobin A1 or A1c, HbA1c) - Glycohemoglobin measures the amount of glucose chemically
attached to your red Blood cells. Since Blood cells live about three months, it tellsus your average
glucose for the last six to eight weeks. A high level suggests poor diabetes control.Normal HbA1C is
below 5 or so, the goal in Diabetes care is to keep it below 7. If this number isabove 8 it is definitely
time to change medications or treatment for your sugar.
Fructosamine
is a blood test that gives us a look at average blood sugar over a 2 to 3 week period.It allows us to
make changes in medication without waiting the full 3 months before we can test theHbA1C again.
Microalbinuria
This is a test measured in the urine. It shows up protein much earlier than the usualurine test done
with the dipstick. If this level is above normal I a diabetic, it is a sign that they shouldstart taking a

special medication to protect the kidney,called an ACE Inhibitor or alternately an ARB.Studies have
shown that these medications can prevent some of the kidney damage done by thediabetes