1 | P a g e BLOOD TEST RESULT INFORMATION
IMPORTANT NOTICE: The test definitions listed below are for informational purposes only and are not comprehensive. They are not intended to diagnose any disease or condition. Please discuss your lab results, whether normal or abnormal, with your physician to determine your need for further evaluation.
Please Note: Your screening may not include all of these tests.
LIPIDS (Complete Lipid Profile)
Total cholesterol is used to estimate risk of developing heart disease. Because high blood cholesterol has been associated with hardening of the arteries (atherosclerosis), heart disease and a raised risk of death from heart attacks, cholesterol testing is considered a routine part of preventive health care.
LDL is a type of lipoprotein that carries cholesterol in the blood. LDL is considered to be undesirable because it deposits excess cholesterol in walls of blood vessel and contributes to hardening of the arteries (atherosclerosis) and heart disease. Hence, LDL cholesterol is often termed “bad” cholesterol.
HDL cholesterol is commonly called the "good cholesterol." HDL removes harmful bad cholesterol from where it doesn't belong. High HDL levels reduce the risk of heart disease - but low levels increase the risk.
Triglycerides are a form of fat and a major source of energy for the body. Most triglycerides are found in fat (adipose) tissue, but some triglycerides circulate in the blood to provide fuel for muscles to work. High levels of triglycerides in the blood are associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood. Certain factors can contribute to high triglyceride levels and to your risk of CVD, including lack of exercise, being overweight, smoking cigarettes, consuming excess alcohol, and medical conditions such as diabetes and kidney disease.
Non-HDL-cholesterol (non-HDL-C) represents the "atherogenic" cholesterol — the cholesterol that can build up in the arteries, form plaques, and cause narrowing of the vessels and blockages. Unlike the calculation of LDL-C, this calculation is not affected by high levels of triglycerides. Your non-HDL-C result may be used to assess your risk for CVD, especially if you have high triglycerides, since high non-HDL-C is associated with increased risk. As recommended by the National Cholesterol Education Program, Adult Treatment Plan III, if you have high triglycerides (greater than 200 mg/dL), the non-HDL-C result can be used as a secondary target of treatments such as lifestyle changes and drugs that aim to lower lipid levels.
METABOLIC (HbA1C)
The HbA1C test is used to screen for and diagnose diabetes. Physicians also use it to monitor the glucose control of diabetics over time. The goal of those with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. The A1C test result gives a picture of the average amount of glucose in the blood over the last few months. It can help you and your doctor know if the measures you are taking to control your diabetes are successful or need to be adjusted.
Estimated Average Glucose is a term introduced by the American Diabetes Association to assist in the interpretation of the A1C test. The eAG translates the A1C result into a number that more closely represents a daily glucose meter reading.
2 | P a g e GENERAL CHEMISTRY (Comprehensive Metabolic Panel-CMP)
The CMP is a panel of tests that reveal important information about the current status of your kidneys, liver, electrolyte and acid/base balance, blood sugar and blood proteins. Abnormal results, and especially combinations of abnormal results, can indicate a problem that needs to be addressed. The CMP includes:
Total Protein is a measure of the total amount of protein in your blood. A low or high total protein does not indicate a specific disease, but it does mean that some additional tests may be required to determine if there is a problem.
Albumin, the most plentiful protein in the blood, is approximately two-thirds of the total protein circulating in your blood. It is produced primarily in the liver and helps keep the fluid portion of the blood within the blood vessels.
When your albumin level is too low, water can leak into other parts of your body and cause swelling. This can be caused by malnutrition, too much water in the body, liver or kidney disease, severe injury or major bone fractures and slow bleeding over a long period of time.
Globulins are a group of proteins in the blood stream that help to regulate the function of the circulatory system.
If the globulin level in the blood is abnormal it can led to health trouble. Proteins not kept at the proper ration can make it difficult for the body to properly fight infection, clot or transport nutrients to the muscles, leading to health difficulties for the patient. Medications can be used to return the globulin level to normal.
Total Bilirubin is the pigment in the blood that makes the plasma or serum part of your blood yellow. When the bilirubin level in the blood is very high for a period of time, the whites of your eyes and your skin may become yellow, this is known as jaundice. Bilirubin comes from the breakdown of old red cells in the blood. A high bilirubin level in the blood can be caused by red blood cells being destroyed (hemolyzed), by liver disease, or by a blockage of bile ducts.
LIVER FUNCTION: (Blood Enzymes- ALT, ALP & AST)
ALP (Alkaline Phosphatase) is an enzyme that is found in many body tissues, but the most important sites are bone, liver, bile ducts and gut. A high level of alkaline phosphates in your blood may indicate bone, liver, or bile duct disease. Certain drugs may also cause increased levels. Growing children, because of bone growth, normally have higher levels than adults. Low values are not generally considered significant.
ALT (Alanine Transaminase, also called ALAT or SGPT): The ALT enzyme is found mainly in the liver.
Damage from alcohol, strenuous exercise and a number of diseases can cause high values for both AST (SGOT) and ALT (SGPT) and should be evaluated by your health care provider. Low values are not generally considered significant.
AST (Aspartate Transaminase, also called AspAT/ASAT/AAT or SGOT): The AST enzyme is found mainly in the heart, liver and muscles. It is released into the blood stream when any of these organs are damaged.
Increased levels are usually associated with liver disease or heart attacks.
Glucose is the primary energy source for all body tissues. The sugars and carbohydrates you eat are ordinarily converted into glucose, which can be either used to produce immediate energy, stored in the liver or as fat throughout the body. High blood glucose (hyperglycemia) after fasting for 12 hours suggests diabetes. Your doctor may want to do further testing. A low glucose level (hypoglycemia) accompanied with symptoms such as weakness, nausea, sweating and difficulty thinking clearly, is suggestive for hypoglycemia. Even if you know you have diabetes, it is important to report any abnormal levels to your health care provider.
3 | P a g e Calcium, one of the most important elements in the body, is essential for maintenance and repair of the bone and teeth, heart function and blood clotting. 99% of the calcium in your body is contained in your bones - only one percent is in the blood. Low levels of calcium in the blood are associated with malnutrition. High levels can be caused by bone disease, excessive use of antacids and milk, cancer, overdosing on Vitamin D and some hormone disorders. Any elevated calcium level should be evaluated by your health care provider.
Sodium, one of the body’s principal minerals regulated by the kidneys, plays an important role in water balance in your body. A high level can be caused by dehydration, excessive salt intake and certain diseases. A low level of sodium may be caused by diarrhea, vomiting, or excessive sweating. Numerous drugs, including diuretics, certain blood pressure medications and steroids may alter the sodium level. Any abnormal value should be evaluated by your healthcare provider.
Potassium, one of the body’s principal minerals found primarily inside cells, helps maintain water balance as well as proper function of nerves and muscles. Low or high levels in the blood are of critical significance and should be evaluated by your health care provider, especially if you are taking a diuretic or heart medication. A high level may indicate kidney or liver disease, too much medication or bodily injury, such as a burn. Low levels of potassium can develop rapidly, most frequently produced as a side effect of drugs that cause increased urination.
Chloride is one of the body’s minerals involved with water balance; most body chloride comes from salt in the diet. A high chloride level may mean severe dehydration, certain kidney disorders or hyperventilation. A low chloride level may result from excessive vomiting, diarrhea, severe burns, excessive sweating or kidney failure.
Borderline low or high levels of chloride have very little significance.
CO2 (carbon dioxide, bicarbonate): Changes in your CO2 level may suggest that you are losing or retaining fluid, which causes an imbalance in your body's electrolytes. CO2 levels in the blood are influenced by kidney and lung function. The kidneys are mainly responsible for maintaining the normal bicarbonate levels.
The concentrations of sodium and potassium are tightly regulated by the body as is the balance between the four molecules. Electrolyte (and acid-base) imbalances can be present with a wide variety of acute and chronic illnesses.
KIDNEY FUNCTION:
BUN (blood urea nitrogen) is a waste product from protein breakdown in the liver. It is excreted by the kidneys. If kidney function is impaired, or if a person is dehydrated, the BUN level will increase. Internal blood loss, high protein diets and/or strenuous exercise can also cause a high BUN level. A low BUN level may be the result of liver disease, poor diet, pregnancy or drinking too much water.
Creatinine: The main function of the kidney is to filter the blood, excreting waste products into the urine while preserving essential elements. One way to measure kidney function is to determine how well the kidney can filter and excrete creatinine, an easily measured waste product of muscle metabolism. In certain types of kidney disease, the ability of the kidneys to clear the blood of creatinine decreases and blood levels of creatinine increase. High values require medical evaluation by your health care provider, especially when associated with high BUN results.
eGFR: The eGFR test is used to screen for and detect early kidney damage and to monitor kidney status. It is performed by ordering a creatinine test and calculating the eGFR. The National Kidney Foundation (NKF) has recommended that it be calculated automatically every time a creatinine test is done.
4 | P a g e Warning signs of kidney disease may include:
Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs, or ankles
Urine that is foamy, bloody, or coffee-colored
A decrease in the amount of urine
Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
Mid-back pain (flank), below the ribs, near where the kidneys are located
High blood pressure (hypertension)
As kidney disease worsens, symptoms may include:
Urinating more or less often
Feeling itchy
Tiredness, loss of concentration
Loss of appetite, nausea and/or vomiting
Swelling and/or numbness in hands and feet
Darkened skin
Muscle cramps
HEMATOLOGY (Complete Blood Count - CBC)
The CBC (Complete Blood Count) test can help determine a person’s general health status. If a patient is having symptoms such as fatigue or weakness or has an infection, inflammation, bruising, or bleeding, the CBC may help diagnose the cause. Many conditions will result with increases or decreases in the cell populations. Some of these conditions may require treatment, while others will resolve on their own.
WBC (White Blood Cell) is a count of the actual number of white blood cells. Both increases and decreases can be significant. An elevated number of white blood cells is called leukocytosis. This can result from bacterial infections, inflammation, leukemia, trauma, intense exercise, or stress.
A decreased WBC count is called leukopenia. It can result from many different situations, such as chemotherapy, radiation therapy, or diseases of the immune system. Counts that continue to rise or fall to abnormal levels indicate that the condition is getting worse. Counts that return to normal indicate improvement.
RBC (Red Blood Cell Count) is a count of the actual number of red blood cells per volume of blood. Both increases and decreases can point to abnormal conditions. A decreased number of RBCs results from either acute or chronic blood loss. Acute blood loss is a rapid depletion of blood volume. Chronic blood loss stems from various conditions that often results in some form of an anemia. Chronic anemias are due to loss of small amounts of blood over a long period of time (bleeding), mechanical destruction of the RBCs, or some physiologic problem such as decreased RBC production. Low levels can be seen with anemia, hemorrhages, cancers and fluid overload in pregnancy. Increased number of RBCs can result from a number of conditions that include dehydration, congenital heart disease, pulmonary diseases, and situations involving tissue hypoxia.
Hemoglobin (HGB) measures the amount of oxygen-carrying protein in the blood.
Hematocrit (HCT) measures the percentage of red blood cells in a given volume of whole blood.
MCV (Mean Corpuscular Volume) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anemia caused by vitamin B12 deficiency.
When the MCV is decreased, your RBCs are smaller than normal (microcytic) as is seen in iron deficiency anemia or thalassemias
5 | P a g e MCH (Mean Corpuscular Hemoglobin) is a calculation of the average amount of oxygen-carrying hemoglobin inside a red blood cell. Macrocytic RBCs are large so they tend to have a higher MCH, while microcytic red cells would have a lower value.
MCHC (Mean Corpuscular Hemoglobin Concentration) is a calculation of the average concentration of hemoglobin inside a red cell. Decreased MCHC values (hypochromia) are seen in conditions where the hemoglobin is abnormally diluted inside the red cells, such as in iron deficiency anemia and in thalassemia.
Increased MCHC values (hyperchromia) are seen in conditions where the hemoglobin is abnormally concentrated inside the red cells, such as in burn patients and hereditary spherocytosis, a relatively rare congenital disorder.
Red Cell Distribution Width (RDW) is a calculation of the variation in the size of your RBCs. In some anemias, such as pernicious anemia, the amount of variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis) causes an increase in the RDW.
PLT (Platelet Count) is the number of platelets in a given volume of blood. Both increases and decreases can point to abnormal conditions of excess bleeding or clotting.
MPV (Mean Platelet Volume) is a machine-calculated measurement of the average size of your platelets. New platelets are larger, and an increased MPV occurs when increased numbers of platelets are being produced.
MPV gives your doctor information about platelet production in your bone marrow.
Neutrophil is a type of white blood cell (leukocyte). Neutrophils normally make up the largest number of circulating WBCs. They move into an area of damaged or infected tissue, where they engulf and destroy bacteria or sometimes fungi.
Neutrophil Absolute - The real number of white blood cells (WBCs) that are neutrophils. The absolute neutrophil count is commonly called the ANC. Neutrophils are key components in the system of defense against infection. An absence or scarcity of neutrophils (a condition called neutropenia) makes a person vulnerable to infection.
Lymphocyte is a type of white blood cell (leukocyte) that normally makes up about 25% of the total white blood cell count but can vary widely. They exist in both the blood and the lymphatic system and are divided into three types:
B lymphocytes (B cells) are antibody-producing cells that are essential for acquired, antigen-specific immune responses. Fully mature B-cells are called plasma cells that produce antibodies, immune proteins that target and destroy bacteria, viruses and other "non-self" foreign antigens.
T lymphocytes (T cells) finish maturing in the thymus and consist of a few different types. Some T cells help the body distinguish between "self" and "non-self" antigens. Others initiate and control the extent of an immune response, boosting it as needed and then slowing it as the condition resolves. Other types of T cells directly attack and neutralize virus-infected or cancerous cells.
Natural killer cells (NK cells) directly attack and kill abnormal cells such as cancer cells or those infected with a virus.
Lymphocyte Absolute - Lower than normal results of the absolute lymphocytes blood test may indicate: AIDS; Viral infection; Cancer; Hodgkin’s disease; Leukemia; HIV infection.
Monocyte is a type of white blood cell (leukocyte), that make up 5-10% of the total white blood cell count.
Monocytes, similar to neutrophils, move to an area of infection and engulf and destroy bacteria. They are associated more often with chronic rather than acute infections. They are also involved in tissue repair and other functions involving the immune system.
6 | P a g e Monocyte Absolute - The absolute monocytes blood test measures the percentage of monocytes in relation to all white blood cells.
Eosinophile is a type of white blood cell (leukocyte), eosinophils respond to infections caused by parasites and play a role in allergic reactions (hypersensitivities). Eosinophils, normally account for about 1-3% of the total white blood cell count.
Eosinophile Absolute - An absolute eosinophil blood test determines the number of eosinophils. Eosinophils become active when you have certain allergic diseases, infections, and other medical conditions.
Basophil is a type of white blood cell (leukocyte), Basophils normally constitute 1% or less of the total white blood cell count but may increase or decrease in certain diseases. They are thought to be involved in allergic reactions.
Basophil Absolute - Measures the number or pecentage of basophils, which are involved in allergy responses.
Higher than normal results of the absolute basophil blood test are called basophilia and may indicate:
Hives
Food allergy
Inflammation
Some forms of leukemia
Crohn’s disease
Hypothyroidism
Hemolytic anemia
PSA (Prostate Specific Antigen) Men Only
PSA is used primarily to screen for prostate cancer. It measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced in the prostate, a small gland that sits below a man's bladder. PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels.
OPTIONAL BLOOD TEST INFORMATION
CARDIOMPO CLEVELAND HEART LAB: The MPO is an enzyme that can help determine if you have inflammation in your arteries from damage to your artery walls. Just as lava in a volcano becomes hot and bursts open through the surface of the earth, plaque buildup inside the artery wall can become inflamed and burst through the wall of the artery to where blood flows. When the plaque ruptures into the blood, this can cause a clot to form. If the clot causes a complete blockage of blood flow, this can cause a heart attack.
This test can help to identify the presence of vulnerable plaque which may be prone to rupture, and may help determine risk for heart attack.
COLON CANCER SCREENING: iFOBT take home colon cancer screening kit. Early detection can make all the difference!
CoQ10: Useful for individuals on statin therapy and those who are at risk for vascular disease. CoQ10 is a fat- soluble, vitamin-like substance required for normal mitochondrial function. Coenzyme Q10 has two major functions within the body. First, it enables the body to function as cells use it to generate energy within their
“powerhouses”. Second, it acts as an anti-oxidant, helping to protect tissues of the body from damage due to toxic molecules known as free radicals.
7 | P a g e DHEA: DHEAS, testosterone, and several other androgens are used to evaluate adrenal function and to distinguish androgen-secreting conditions that are caused by the adrenal glands from those that originate in the ovaries or testes. DHEAS can be measured to help diagnose tumors in the cortex of the adrenal gland (adrenocortical tumors), adrenal cancers, and congenital adrenal hyperplasia or adult-onset adrenal hyperplasia and to separate these conditions from ovarian tumors and cancers.
ESTRADIOL: To measure or monitor your estrogen levels if you are a woman who has unexplained abnormal menstrual cycles, abnormal or heavy bleeding, infertility, symptoms of menopause, or any other hormonal alterations; also used to test for fetal-placental status during early stages of pregnancy and to evaluate feminization, the presence of female-like characteristics in males
HELICOBACTER PYLORI: This test is used to diagnose infection due to Helicobacter pylori. A positive test for H. pylori indicates that a person's gastrointestinal pain may be caused by a peptic ulcer due to this bacterium. Treatment with a combination of antibiotics and other medications will be prescribed to kill the bacteria and stop the pain and the ulceration.
Testing for H. pylori may be repeated following several weeks of treatment to determine if it was effective.
However, the blood antibody test cannot be used for this purpose since antibodies to H. pylori may persist even after an infection is resolved; usually the stool or breath test will be used for this purpose.
HEPATITIS C VIRUS ANTIBODY: Hepatitis C tests are used to screen for and diagnose a hepatitis C virus (HCV) infection, to guide therapy and/or to monitor the treatment of an HCV infection.
An HCV antibody test is used to screen for infection. It detects the presence of antibodies to the virus, indicating exposure to HCV. This test cannot distinguish between someone with an active or a previous HCV infection.
There is some evidence that if the test is "weakly positive," it may be a false positive. The Centers for Disease Control and Prevention (CDC) recommends that all positive antibody tests be followed by an HCV RNA test that detects viral RNA in the blood to determine whether or not the person has an active infection.
The CDC recommends screening for HCV infections with an HCV antibody test when people:
Have ever injected illegal drugs
Received a blood transfusion or organ transplant before July 1992*
Have received clotting factor concentrates produced before 1987
Were ever on long-term dialysis
Are children born to HCV-positive women
Have been exposed to someone with hepatitis C
Are health care, emergency medicine, or public safety workers who had needlesticks, sharps, or mucosal exposure to HCV-positive blood
Have evidence of chronic liver disease
Have HIV
Were born between 1945 and 1965, regardless of other risk factors for HCV
HOMOCYSTEINE: Elevated levels may increase your risk of Stroke, Heart Disease and Alzheimer’s Disease.
hs-CRP (High Sensitivity C Reactive Protein): Identifies inflammation in the arteries (vascular disease).
NMR ADVANCED LIPID PANEL: State-of-the-Art method for testing lipoproteins. Establishes the most effective treatment for abnormal cholesterol levels.
OMEGA 3 & OMEGA 6: Evaluates levels. Used to help identify individuals who may benefit from supplementation. Omega-3 fatty acids (also known as n-3 fatty acids) are polyunsaturated fatty acids that are essential nutrients for health. We need omega-3 fatty acids for numerous normal body functions, such as
8 | P a g e controlling blood clotting and building cell membranes in the brain, and since our bodies cannot make omega-3 fats, we must get them through food. Omega-3 fatty acids are also associated with many health benefits, including protection against heart disease and possibly stroke. New studies are identifying potential benefits for a wide range of conditions including cancer, inflammatory bowel disease, and other autoimmune diseases such as lupus and rheumatoid arthritis.
Along with Omega-3 fatty acids, Omega-6 fatty acids play a crucial role in brain function, as well as normal growth and development. Also known as polyunsaturated fatty acids (PUFAs), they help stimulate skin and hair growth, maintain bone health, regulate metabolism, and maintain the reproductive system.
The PLAC Test: The PLAC Test is a blood test that measures the amount of lipoprotein-associated phospholipase A2, or Lp-PLA2, an enzyme associated with inflammation in the walls of your arteries. Elevated levels of this enzyme indicate an increased risk of heart attack and stroke. This test helps measure vulnerable plaque in your arteries.
PSA (Prostate Specific Antigen): The PSA test is used primarily to screen for prostate cancer. It measures the amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced in the prostate, a small gland that sits below a man's bladder. PSA is mostly found in semen, which also is produced in the prostate. Small amounts of PSA ordinarily circulate in the blood. The PSA test can detect high levels of PSA that may indicate the presence of prostate cancer. However, many other conditions, such as an enlarged or inflamed prostate, can also increase PSA levels.
TESTOSTERONE: Testosterone testing is used to diagnose several conditions.
Some of these conditions are:
Decreased sex drive in men and women
Erectile dysfunction in men
Infertility in men and women
Testicular tumors in men
Hypothalamus or pituitary disorders
The normal range for testosterone levels in men is broad and varies by stage of maturity and age. It is normal for testosterone levels to slowly decline starting in the third decade of life. The rate may increase in men who are obese or chronically ill and with the use of certain medications.
A low testosterone level (hypogonadism) may be due to:
Hypothalamic or pituitary disease
Genetic diseases that can cause decreased testosterone production in young men (Klinefelter, Kallman, and Prader-Willi syndromes) or testicular failure and infertility (as in myotonic dystrophy, a form of muscular dystrophy)
Impaired testosterone production because of acquired damage to the testes, such as from alcoholism, physical injury, or viral diseases like mumps
Increased testosterone levels in males can indicate:
Testicular tumors
Adrenal tumors that are producing testosterone
Use of androgens (also called anabolic steroids)
Early puberty of unknown cause in boys
Hyperthyroidism
Congenital adrenal hyperplasia
TSH (Thyroid Stimulating Hormone) is the pituitary hormone which controls thyroid gland function. It stimulates the thyroid to produce thyroid hormone. When the thyroid gland fails, due to primary disease of the thyroid, pituitary TSH increases. This condition is called primary hypothyroidism. In contrast, when the thyroid gland is overactive and producing too much thyroid hormone, the serum TSH decreases. This is called primary
9 | P a g e hyperthyroidism. Both primary hypothyroidism and hyperthyroidism can be detected by the sensitive TSH method. In addition, the TSH test can tell if your dose of thyroid hormone is correct, should you be taking that medication.
VITAMIN B12 and folate are used to help diagnose the cause of macrocytic anemia. Folate, B12, and an assortment of other tests help evaluate the general health and nutritional status of a patient with signs of significant malnutrition or malabsorption. This may include people with alcoholism and those with conditions associated with malabsorption such as celiac disease, Crohn’s disease, and cystic fibrosis. B12 and folate may also be ordered to help diagnose the cause of mental or behavioral changes, especially in the elderly. Drugs that can decrease B12 and folic acid levels include oral contraceptives, estrogens, alcohol, and some antibiotics.
VITAMIN D: Vital for strong bones, immune function and prevention of some cancers. Deficiencies of Vitamin D at any stage of life can have devastating consequences.
