7-11-06In polycythemia_vera@yahoogroups.com, "Tony"
wrote:
If anyone has a CT with dye, his/her kidney function must be checked.
It is a simple blood test plus don't forget if you had a recent blood
test showing kidney function is fine, they don't order another. Not
all Cat Scans are done with dye. It is not a problem with PV unless
one is misdiagnosed with having PV when he/she may have a secondary
poly caused by a bad kidney. If this is the case and one has a Cat Scan
done with DYE and a compromised kidney, that dye may finish it off.
Remember that not all Cat Scans are done with dye. You can have a CT
done with nothing, with dye injected with IV, or a drink. Only the dye
is bad for a compromised kidney. Tony
Definitions of Commonly Used Terms:
Complete Blood Count White Cell Count relates to
the body's immune system. Recent colds, allergies, infections, or chemical
exposures may cause this value to be high or low.
Red Cell Count refers to the red blood cells. These cells carry oxygen
in the blood. Low values are commonly seen in individuals with certain
types of anemia.
Hemoglobin (HgB) is the oxygen carrying component in the red blood
cell. It is formed in the bone marrow. Low values are commonly seen
in individuals with certain types of anemia.
Hematocrit (Hct) - is the volume (percentage) of red blood cells in
whole blood. Low values are commonly seen in individuals with certain
types of anemia.
MCV stands for mean cell volume. This is a measure of the average
size of the red blood cells.
MCH stands for mean cell hemoglobin. This is a measure of the amount
of hemoglobin associated with each red cell.
MCHC stands for mean cell hemoglobin concentration. This value represents
the mean hemoglobin concentration in each red blood cell. Platelet Count
refers to the disk shaped structures found in the blood, primarily known
for their role in the coagulation process.
Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils are
the different types of white blood cells. A detailed look at all of
the white cells will provide a physician with useful information regarding
the status of the immune system.
RBC Morphology refers to the size and the shape of the red blood cells
obtained in your blood sample. Blood Chemistry Panel Glucose is a measure
of sugar content in your blood. This value is watched closely to evaluate
diabetes or hypoglycemia. This test needs to be performed in a fasted(no
eating) state. Your blood sugar should be between 60-120 mg/dl to be
considered normal.
Urea Nitrogen (BUN) is a waste product of protein metabolism. It is
produced in the liver and excreted by the kidneys. When protein metabolism
is not working properly, high values may occur. Low values need not
always be followed with your personal physician
Iron is the most sensitive indicator of your iron stores (in the absence
of liver disease or inflammation). Low values may represent certain
types of anemia and should be evaluated by your personal physician.
Creatinine is another waste product of protein metabolism. It represents
the function of the kidneys. A low value is not clinically significant.
Iron is the most sensitive indicator of your iron stores (in the absence
of liver disease or inflammation). Low values may represent certain
types of anemia and should be evaluated by your personal physician.
Calcium is involved in many physiologic processes. A normal blood
calcium level is essential for normal function of the heart, nerves,
and muscles. It is also involved in the coagulation process.
Phosphorus is an essential element in the diet. It is a major component
of the mineral phase of bone and occurs in all tissues, being involved
in almost all metabolic processes.
Calcium is controlled by the kidneys and parathyroid glands. Processing
errors may affect this value.Uric Acid is a constituent in the blood
which transports nitrogen in the body. It is normally excreted in the
urine to rid the body of nitrogen. Values that are high may indicate
gout, arthritis or certain kidney problems. A low value is not clinically
significant.
Sodium is an ion that is important in the conduction of nerves, contraction
of muscles, and functioning of cells. It is controlled primarily by
the kidneys and adrenal glands.
Potassium is important for muscles and nerves to function properly.
It is controlled by the kidneys. This value is watched very closely
if one is taking diuretics or cardiovascular medications. If the blood
sample is not processed properly, high values may occur.
Chloride, like sodium and potassium, is an ion that is important in
the functioning of cells. It is primarily controlled by the kidneys
and adrenal glands.
Total Protein is the total amount of protein circulating in the blood.
This value represents your general nutritional habits.
Albumin is a carbohydrate-free plasma protein which transports fatty
acids, bilirubin, and poorly saturated hormones. It also serves as a
reserve store of protein. High values are not clinically significant.
Globulin is a protein fraction. Elevated values may indicate chronic
infections and should be followed-up by your personal physician.
A/G Ratio is a ratio between Albumin and Globulin. Provided Albumin
and Globulin values are normal, a high or low ratio is not significant.
Total Bilirubin is a bile pigment. It normally circulates in the plasma
and is taken up by liver cells. High levels of bilirubin may result
in jaundice.
LDH stands for lactate dehydrogenase. It is an enzyme involved in
the breakdown of lactic acid. Anything which causes cellular damage,
including heart attacks, liver disease, and blood drawing itself, may
cause higher values.
Alkaline Phosphatase is an enzyme found primarily in bones and the
liver. Values for pregnant women have found to be elevated, however
low values are probably not significant. SGOT stands for serum glutamic
oxaloacetic transaminase.
SGOT is a liver enzyme involved in cellular functions of the heart
muscle and liver. Alcohol consumption, liver disease, and other normal
factors have been shown to raise this value. Low values are probably
not clinically significant.
SGPT stands for serum glutamic pyruvic transaminase. SGPT, like SGOT,
is an enzyme involved in the functions of heart, liver, and muscle cells.
Alcohol consumption has been shown to increase this value.
GGT stands for Gamma Glutamyl Transpedtidase. Similar to SGOT and
SGPT, GGT is an enzyme involved in the function of the liver, heart,
and muscle cells. Alcohol consumption, liver disease, heart attacks,
recent heavy physical exertion, and other normal factors have been shown
to raise this value. Low values are probably not significant.
Cholesterol is used to make essential body substances, such as cell
walls and hormones. High levels of cholesterol have been associated
with an increased risk for heart disease. Low levels of cholesterol
are preferred.
Triglycerides are blood fats that are the usual storage form of lipids
in the body. This value can be dramatically affected by a recent meal
or recent physical activity. Thus, an eight hour fast with no significant
activity is required for accurate results.
HDL Cholesterol is a High Density Lipoprotein, which is commonly referred
to as the "good" cholesterol. HDL Cholesterol is a transport protein
that carries cholesterol away from the artery walls for removal from
the body. The higher the HDL value, the lower the risk of cardiovascular
disease. Exercise and weight loss have been shown to increase your HDL
level, while smoking has been shown to decrease it.
LDL Cholesterol is a Low Density Lipoprotein, which is commonly referred
to as the "bad" cholesterol. LDL Cholesterol, like HDL Cholesterol,
is a transport protein. However, LDL transports cholesterol to the arteries.
The lower the LDL Cholesterol concentration, the lower the risk of cardiovascular
disease. A low-fat, low-cholesterol diet has been shown to decrease
this value. Cholesterol/HDL Ratio is a ratio of Total Cholesterol to
HDL Cholesterol. This ratio has been shown to be a good predictor of
cardiovascular disease risk, with the lower the ratio the better. A
combination of regular aerobic exercise and good nutritional practices
have been shown to improve this ratio.
Hematology
HEMATOCRIT (HCT) Hematocrit is the percentage of red blood cells in
whole blood. It is an important determinant of anemia (decreased), polycythemia
(decreased), dehydration (elevated), increased R.B.C. breakdown in the
spleen (elevated), or possible dehydration (elevated). The word hematocrit
means, 'to separate blood,' a procedure that is followed after the blood
draw through the proper use of a centrifuge. Normal Adult Female Range:
37 - 47% Optimal Adult Female 42% Normal Adult Male Range 40 - 54% Optimal
Adult Male: 47 Normal Newborn Range: 50 - 62% Optimal Newborn Reading:
56
HEMOGLOBIN (HGB) Hemoglobin is the main transport of oxygen and carbon
dioxide in the blood. It is composed of globin a group of amino acids
that form a protein and heme which contains iron atoms and the red pigment,
porphyrin. As with Hematocrit, it is an important determinant of anemia
(decreased), dehydration (increased), polycythemia (decreased), poor
diet/nutrition, or possibly a malabsorption problem. Normal Adult Female
Range: 12 - 16% Optimal Adult Female: 14 Normal Adult Male Range: 14
- 18% Optimal Adult Male Reading: 16 Normal Newborn Range: 14 - 20%
Optimal Newborn Reading: 17 MCH (Mean Corpuscular Hemoglobin)
MCH = Hemoglobin x 10/R.B.C. Mean Corpuscular Hemoglobin (MCH) gives
the average weight of hemoglobin in the red blood cell. Due to its use
of red blood cells in its calculation, MCH is not as accurate as MCHC
in its diagnosis of severe anemias. Decreased MCH is associated with
microcytic anemia. Increased MCH is associated with macrocytic anemia.
Normal Adult Range: 27 - 33 pg Optimal Adult Reading: 30
MCV (Mean Corpuscular Volume) MCV = Hematocrit x 10/R.B.C. The Mean
Corpuscular Volume reflects the size of red blood cells by expressing
the volume occupied by a single red blood cell. Increased readings may
indicate macrocytic anemia, Pyridoxine or Folic Acid deficiency. Decreased
readings may indicate microcytic anemia, possibly caused by iron deficiency.
Normal Adult Range: 80 - 100 fl Optimal Adult Reading: 90 Higher ranges
are found in newborns and infants.
MCHC (Mean Corpuscular Hemoglobin Concentration) MCHC = Hemoglobin
x 100/Hematocrit This test measures the average concentration of hemoglobin
in red blood cells. It is most valuable in evaluating therapy for anemia
because Hemoglobin and Hematocrit instead of R.B.C. are used in the
calculation. Low MCHC means that a unit of packed R.B.C.'s contain less
hemoglobin than normal and a high MCHC means that there is more hemoglobin
in a unit of R.B.C.'s. Increased MCHC is seen in spherocytosis, and
not seen in pernicious anemia. Decreased levels may indicate iron deficiency,
blood loss, B6 deficiency of thalassemia. Normal Adult Range: 32 - 36
% Optimal Adult Reading: 34 Higher ranges are found in newborns and
infants.
R.B.C. (Red Blood Cell Count) The red blood cell's main function is
to carry oxygen to the tissues and to transfer carbon dioxide to the
lungs. This process is possible through the R.B.C. containing hemoglobin
which combines easily with oxygen and carbon dioxide. Normal Adult Female:
3.9 - 5.2 mill/mcl Optimal Adult Female: 4.55 Normal Adult Male Range:
4.2 - 5.6 mill/mcl Optimal Adult Male: 4.9 Lower ranges are found in
Children, newborns and infants Immune System.
W.B.C. (White Blood Cell Count) The white blood cell's main function
is to fight infection, defend the body by phagocytosis against invasion
by foreign organisms, and to produce, or at least transport and distribute,
antibodies in the immune response. There are a number of types of leukocytes
(see differential) that are classified as follows; Granulocytes Nongranulocytes
Band Neutrophils Lymphocytes Neutrophils Monocytes Eosinophils Basophils
Each cell, or leukocyte, has a different job in the body, which is explained
in the Differential section. An increase in all types of white blood
cells simultaneously is rarely seen. Some diseases such as measles,
pertussis and sepsis, have increased white blood cell counts so high
that it suggests leukemia. This is a type of temporary leukocytosis
which must be distinguished from leukemia by running more than one blood
test. Other potential causes of leukocytosis include leukemia, malignancies,
drugs, toxins, tissue necrosis and polycythemia vera. Decreased levels
of white blood cells, leukopenia, may occur during certain viral infections,
hypersplenism, drugs, primary bone disorders, fungal infections, metastatic
tumors, and iron deficiency anemia. Normal Adult Range: 3.8 - 10.8 thous/mcl
Optimal Adult Reading: 7.3 Higher ranges are found in children, newborns
and infants.
NEUTROPHILS NEUTROPHIL COUNT Also known as Granulocytes or segmented
neutrophils, this is the main defender of the body against infection
and antigens. High levels may indicate an active infection. A low count
may indicate a compromised immune system or depressed bone marrow (low
neutrophil production). Normal Adult Range: 48 - 73 % Optimal Adult
Reading: 60.5 Normal Children's Range: 30 - 60 % Optimal Children's
Reading: 45
LYMPHOCYTES LYMPHOCYTE COUNT Lymphocytes are involved in protection
of the body from viral infections such as measles, rubella, chickenpox,
or infectious mononucleosis. Elevated levels may indicate an active
viral infection. Depressed levels may indicate an exhausted immune system
or an active infection if the neutrophils are elevated. Normal Adult
Range: 18 - 48 % Optimal Adult Reading: 33 Normal Children's Range:
25 - 50 % Optimal Children's Reading: 37.5
MONOCYTES MONOCYTE COUNT These cells are helpful in fighting severe
infections, are considered the body's second line of defense against
infection and are the largest cells in the blood stream. Elevated levels
are seen in tissue breakdown, chronic infections, carcinomas, leukemia
(monocytic) and lymphomas. Low levels may be indicative of a state of
good health. Normal Adult Range: 0 - 9 % Optimal Adult Reading: 4.5
EOSINOPHILS EOSINOPHIL COUNT Eosinophils are used by the body to protect
against allergic reactions and parasites. Therefore, elevated levels
may indicate an allergic response. A low count is normal. Normal Adult
Range: 0 - 5 % Optimal Adult Reading: 2.5
BASOPHILS BASOPHIL COUNT Basophilic activity is not fully understood
but it is known to carry histamine, heparin and serotonin. High levels
are found in allergic reactions. Low levels are normal. Normal Adult
Range: 0 - 2 % Optimal Adult Reading: 1
Lipids
CHOLESTEROL Cholesterol is a critical fat that is a structural component
of cell membrane and plasma lipoproteins, and is important in the synthesis
of steroid hormones, glucocorticoids, and bile acids. Mostly synthesized
in the liver, some is absorbed through the diet, especially one high
in saturated fats. High density lipoproteins (HDL) is desired as opposed
to the low density lipoproteins (LDL), two types of cholesterol. Elevated
cholesterol has been seen in artherosclerosis, diabetes, hypothyroidism
and pregnancy. Low levels are seen in depression, malnutrition, liver
insufficiency, malignancies, anemia and infection. Normal Adult Range:
120 - 240 mg/dl Optimal Adult Reading: 180
TRIGLYCERIDES Triglycerides, stored in adipose tissues as glycerol,
fatty acids and monoglyceroids, are reconverted as triglycerides by
the liver. Ninety percent of the dietary intake and 95% of the fat stored
in tissues are triglycerides. Increased levels may be present in artherosclerosis,
hypothyroidism, liver disease, pancreatitis, myocardial infarction,
metabolic disorders, toxemia, and nephrotic syndrome. Decreased levels
may be present in chronic obstructive pulmonary disease, brain infarction,
hyperthyroidism, malnutrition, and malabsorption. Normal Adult Range:
0 - 200 mg/dl Optimal Adult Reading: 100
LDL (Low Density Lipoprotein) LDL is the cholesterol rich remnants
of the lipid transport vehicle VLDL (very-low density lipoproteins).
There have been many studies showing correlations between high levels
of LDL and arterial artherosclerosis. Due to the expense of direct LDL
measurement, a calculation known as the Friedewald formula is used (Total
Cholesterol - HDL Cholesterol - Triglycerides/5). When Triglyceride
levels are greater than 400, this method is not accurate. Increased
levels are seen in high cholesterol diets, nephrotic syndromes, multiple
myeloma, hepatic obstruction or disease, anorexia nervosa, diabetes
chronic renal failure, and premature coronary heart disease. Decreased
levels are associated with Tangier disease, Apo-C-II deficiency, hyperthyroidism,
chrnic anemias, hepatocellular disease, Reye's syndrome, acute stress,
inflammatory joint disease, and chronic pulmonary disease. Normal Adult
Range: 62 - 130 mg/dl Optimal Adult Reading: 81 mg/dl
HDL (High Density Lipoprotein) HDL is the cholesterol carried by alpha
lipoproteins. A high level of HDL is an indication of a healthy metabolic
system if there is no sign of liver disease or intoxication. Two mechanisms
explain how HDL offers protection against chronic heart disease. First,
HDL inhibits cellular uptake of LDL. Second, it serves as a carrier
that removes cholesterol from the peripheral tissues and transports
it back to the liver for catabolism and excretion. Decreased levels
are associated with an increased risk for coronary heart disease, poorly
controlled diabetes mellitus, hypertriglycerdemia, hepatocellular diseases,
chronic renal failure and nephrotic syndrome. Normal Adult Range: 35
- 135 mg/dl Optimal Adult Reading: 85 mg/dl
CHOLESTEROL/HDL RATIO According to data from LabCorp of America, Data
from various studies suggest that the ratio of total cholesterol/HDL
may provide a 'rule of thumb' guide to predicting increased risk to
coronary heart disease. The following chart is used commonly to measure
risk factors for CHD. Risk Total Cholesterol/HDL Ratio Men Women 1Z2
Average 3.42 3.27 Average 4.97 4.44 2 x Average 9.55 7.05 3 x Average
23.99 11.04 Normal Adult Range: 1 - 6 Optimal Adult Reading: 3.5
Enzymes and Hepatic Function
BILIRUBIN, TOTAL A byproduct of the breakdown of red blood cells in
the liver, bilirubin is a good indication of the liver's function. Excreted
into the bile, bilirubin gives the bile its pigmentation. Elevated in
liver disease, mononucleosis, hemolytic anemia, low levels of exposure
to the sun, and toxic effects of some drugs. Decreased levels are seen
in people with an inefficient liver, excessive fat digestion, and possibly
a diet low in nitrogen bearing foods. Normal Adult Range 0 - 1.3 mg/dl
SGOT (Serum Glutamic-Oxalocetic Transaminase - AST) Serum Glutamic
Oxalocetic Transaminase or AST is an enzyme found primarily in the liver,
heart, kidney, pancreas, and muscles. Elevated in tissue damage, especially
heart and liver. Decreased levels can be found in Vitamin B deficiency
and pregnancy. Normal Adult Range: 0 - 42 U/L Optimal Adult Reading:
21
SGPT (Serum Glutamic-Pyruvic Transaminase - ALT) Serum Glutamic Pyruvic
Transaminase or ALT is an enzyme found primarily in the liver but also
in the heart and other tissues. It is more useful in diagnosing liver
function than SGOT levels are. Decreased SGPT in combination with increased
cholesterol levels is seen in congested liver cases. Increased levels
are seen in mononucleosis, alcoholism, liver damage, kidney infection,
chemical pollutants or myocardial infarction. Normal Adult Range: 0
- 48 U/L Optimal Adult Reading: 24
ALKALINE PHOSPHATASE Produced in the cells of bone and the liver with
some activity in the kidney, intestine, and placenta, it is mostly found
in an alkaline state with a pH of 9. Increased levels are seen extensively
as a tumor marker, in bone injury, pregnancy, or skeletal growth (elevated
readings). Growing children have normally higher levels of this enzyme.
Decreased levels are sometimes found in hypoadrenia, protein deficiency,
malnutrition and a number of vitamin deficiencies. Normal Adult Range:
20 - 125 U/L Optimal Adult Reading: 72.5 Normal Children's Range: 40
- 400 U/L Optimal Children's Reading: 220
GGT (Gamma-Glutamyl Transpeptidase) GGT is believed to be involved
in the transport of amino acids and peptides into cells as well as glutithione
metabolism. GGT is mainly found in liver cells and as such is extremely
sensitive to alcohol use. Elevated levels may be found in liver disease,
alcoholism, bile-duct obstruction, cholangitis, drug abuse, and in some
cases excessive magnesium ingestion. Decreased levels can be found in
hypothyroidism, hypothalamic malfunction and low levels of magnesium.
Normal Adult Female Range: 0 - 45 U/L Optimal Female: 22.5 Normal Adult
Male Range: 0 - 65 U/L Optimal Male: 32.5
LDH (Lactic Acid Dehydrogenase) Lactic acid dehydrogenase is an intracellular
enzyme found primarily in the kidney, heart, skeletal muscle, brain,
liver and lungs. Increases are usually found in cellular death and/or
leakage from the cell. In some cases it can be useful in confirming
myocardial or pulmonary infarction (only in relation to other tests).
Decreased levels of the enzyme may be seen in cases of malnutrition,
hypoglycemia, adrenal exhaustion, or low tissue or organ activity. Normal
Adult Range: 0 - 250 U/L Optimal Adult Reading: 125
Electrolytes
SODIUM Sodium is the most abundant cation in the blood and its chief
base. It functions in the body to maintain osmotic pressure, acid-base
balance and to transmit nerve impulses. Increased levels are associated
with dehydration, Conn's syndrome, primary aldosteronism, coma, Cushing's
disease, diabetes insipidus, and tracheobronchitis. Decreased levels
are seen in severe burns, congestive heary failure, excessive fluid
loss, Addison?s disease, severe nephritis, pyloric obstruction, malabsorption,
diabetic acidosis, diuretics, edema, and hypothyroidism. Normal Adult
Range: 135-146 mEq/L Optimal Adult Reading: 140.5
POTASSIUM Potassium is the major intracellular cation in the blood.
It, along with sodium, helps to maintain osmotic balance and in also
involved in acid-base balance. It is needed for proper nerve and muscle
action. Increased potassium is sometimes seen in renal failure, dehydration,
obstruction, trauma, cell damage, Addison?s disease, uncontrolled diabetes
and decreased insulin. Decreased levels are associated with diarrhea,
starvation, vomiting, stress, malabsorption, severe burns, primary aldosteronism,
excessive licorice ingestion, respiratory alkalosis, renal tubular acidosis,
drugs, and treatment of megaloblastic anemia with vitamin B12 or folic
acid.. Normal Range: 3.5 - 5.5 mEq/L Optimal Adult Reading: 4.5
CHLORIDE Chlorides significance relates to its maintenance of cellular
integrity through it influence on osmotic pressure. It also helps monitor
acid-base balance and water balance. Elevated levels are related to
acidosis as well as excessive water crossing the cell membrane. Decreased
levels with decreased serum albumin may indicate water deficiency (edema).
Normal Adult Range: 95-112 mEq/L Optimal Adult Reading: 103
CO2 (Carbon Dioxide) The CO2 level is related to the respiratory exchange
of carbon dioxide in the lungs and is part of the body's buffering system.
Generally when used with the other electrolytes, it is a good indicator
of acidosis and alkalinity. Elevated CO2 is seen in severe vomiting,
emphysema, aldosteronism and the use of mercurial diuretics. Decrease
CO2 is associated with severe diarrhea, starvation, acute renal failure,
salicylate toxicity, and diabetic acidosis. Normal Adult Range: 22-32
mEq/L Optimal Adult Reading: 27 Normal Children's Range - 20 - 28 mEq/L
Optimal Children's: 24
CALCIUM The most abundant mineral in the body, it is involved in bone
metabolism, protein absorption, fat transfer, muscular contraction,
transmission of nerve impulses, blood clotting and cardiac function.
It is highly sensitive to elements such as magnesium, iron, and phosphorus
as well as hormonal activity, vitamin D levels, alkalinity and acidity,
and many drugs. Increased calcium levels may be associated with hyperparathyroidism,
metastatic bone cancers, cancers of the lung, breast, thyroid, kidney,
liver, and pancreas as well as Hodgkin's disease, lymphomas, leukemia,
multiple myelomas, primary squamous cell carcinomas, tuberculosis, sarcoidosis,
hyperthyroidism, Paget's disease, bone fractures, excessive vitamin
D intake, and renal transplant. Decreased levels are associated with
hypoparathyroidism, hyperphosphatemia, malabsorption, acute pancreatitis,
renal failure, alkalosis, osteomalacia, vitamin D deficiency, malnutrition
and alcoholism. Normal Adult Range: 8.5-10.3 mEq/dl Optimal Adult Reading:
9.4 Normal Children's Reading: 9-11 mEq/dl Optimal Children's: 10
PHOSPHORUS Phosphorus is an abundant element found in most tissues
and cells. It is inversely related to the calcium level. When calcium
is increased, phosphorus tends to decrease and vice versa. Proper blood
draw procedures are necessary in order to avoid falsely elevated readings.
Phosphorus is needed for its buffering action, calcium transport and
osmotic pressure. Increased levels are seen in renal insufficiency,
hypoparathyroidism, excessive intake of vitamin D, hypocalcemia, bone
tumors, Addison's disease, acromegaly, and liver disease. Decreased
levels are associated with hyperparathyroidism, rickets, osteomalacia,
vitamin D deficiency, diabetic coma, liver disease, dialysis, vomiting,
intravenous glucose in a nondiabetic patient, severe malnutrition and
gram-negative septicemia. Normal Adult Range: 2.5 - 4.5 mEq/dl Optimal
Adult Reading: 3.5 Normal Children's Range: 3 - 6 mEq/dl Optimal Children's
Range: 4.5
Nitrogen B.U.N. (Blood Urea Nitrogen) The nitrogen component of Urea,
B.U.N. is the end product of protein metabolism and its concentration
is influenced by the rate of excretion. Excessive protein intake, kidney
damage, certain drugs, low fluid intake, intestinal bleeding, exercise
or heart failure can cause increases. Decreased levels may be due to
a poor diet, malabsorption, liver damage or low nitrogen intake. Normal
Adult Range: 7 - 25 mg/dl Optimal Adult Reading: 16
CREATININE Creatinine is the waste product of muscle metabolism. Its
level is a reflection of the body's muscle mass. Low levels are sometimes
seen in kidney damage, protein starvation, liver disease or pregnancy.
Elevated levels are sometimes seen in kidney disease, muscle degeneration,
or some drugs involved in impairment of kidney function Normal Adult
Range: .7 - 1.4 mg/dl Optimal Adult Reading: 1.05
URIC ACID Uric acid is the end product of purine metabolism and is
normally excreted through the urine. High levels are noted in gout,
infections, kidney disease, alcoholism, high protein diets, and with
toxemia in pregnancy. Low levels may be indicative of kidney disease,
malabsorption, poor diet, liver damage or an overly acid kidney. Normal
Adult Female : 2.5 - 7.5 mg/dl Optimal Adult Female : 5.0 Normal Adult
Male: 3.5 - 7.5 mg/dl Optimal Adult Male: 5.5
Protein
PROTEIN, TOTAL Proteins are the most abundant compounds in serum.
The protein makeup of the individual is of important diagnostic significance
because of proteins involvement in enzymes, hormones and antibodies
as well as osmotic pressure balance, maintaining acid-base balance and
as a reserve source of nutrition for the bodies tissues and muscles.
The major serum proteins measured are Albumin and Globulin (alpha1,
alpha2, beta and gamma). Decreased levels may be due to poor nutrition,
liver disease, malabsorption, diarrhea, or severe burns. Increased levels
are seen in lupus, liver disease, chronic infections, alcoholism, leukemia,
and tuberculosis amongst many others. Careful review of the individual
albumin, globulin and A/G ratios are recommended. Normal Adult Range:
6.0 -8.5 g/dl Optimal Adult Reading: 7.25
ALBUMIN Albumin is the major constituent of serum protein (usually
over 50%). It is manufactured by the liver from the amino acids taken
through the diet. It helps in osmotic pressure regulation, nutrient
transport and waste removal. High levels are seen in liver disease,
shock, dehydration, or multiple myeloma. Lower levels are seen in poor
diets, diarrhea, fever, infection, liver disease, inadequate iron intake,
third-degree burns and edemas or hypocalcemia. Normal Adult Range: 3.2
- 5.0 g/dl Optimal Adult Reading: 4.1
GLOBULIN (Calculated) Globulin, a larger protein than albumin, is
important for its immunologic responses, especially its gamma portion
(IgA, IgG, IgM, and IgE). Globulins have many diverse functions such
as, the carrier of some hormones, lipids, metals, and antibodies. When
chronic infections, liver disease, rheumatoid arthritis, myelomas, and
lupus are present, elevated levels are seen. You may find lower levels
in immune compromised patients, poor dietary habits, malabsorption and
liver or kidney disease. Normal Adult Range: 2.2 - 4.2 g/dl Optimal
Adult Reading: 3.2
A/GRATIO (Albumin/Globulin Ratio) (Calculated) A/G ratio is an important
indicator of disease states although a high level is not considered
clinically significant. Low levels may be indicative of liver disease
malabsorption, leukemia, rheumatoid arthritis, lupus, or bacterial pneumonia.
Normal Adult Range: 0.8 - 2.0 Optimal Adult Reading: 1.9
Ratios
ANION GAP (Sodium + Potassium - CO2 + Chloride) The anion gap is used
to measure the concentration of cations (sodium and potassium) and the
anions (chloride and CO2) in the extracellular fluid of the blood. Numerous
clinical implications can be gathered from the Anion Gap. An increased
measurement is associated with metabolic acidosis due to the overproduction
of acids (a state of alkalinity is in effect). Decreased levels may
indicate metabolic alkalosis due to the overproduction of alkaloids
(a state of acidosis is in effect). Normal Adult Range: 4 - 14 Optimal
Adult Reading: 9
BUN/CREATININE A high reading in this calculation is normally indicative
of too much BUN being formed. A low reading may show that the creatinine
is not being cleared effectively by the kidney. This calculation is
a good measurement of kidney and liver function. Normal Adult Range:
6 -25 Optimal Adult Reading: 15.5
CALCIUM/PHOSPHORUS (Calculated) Due to the delicate balance between
calcium and phosphorus in the system, this calculation is helpful in
noting subtle and acute imbalances in the relationship between the two
elements. Decreased levels are seen in some autoimmune disorders like
fibromyaligia. Increased levels in over supplementation of Calcium.
Normal Adult Range: 2.3 - 3.3 Optimal Adult Reading: 2.8 Normal Children's
range: 1.3 - 3.3 Optimal Children's Reading: 2.3
SODIUM/POTASSIUM (Calculated) These are the two major blood electrolytes,
sodium is the extracellular cation and potassium is the intracellular
cation. This is an important ratio to review and act upon when subtle
or acute imbalances are noted. Normal Adult Range: 26 - 38 Optimal Adult
Reading: 32
Thyroid Thyroxine (T4) Thyroxine is the thyroid hormone that contains
four atoms of iodine. It is used to evaluate thyroid function. It is
the direct measurement of total T4 concentration in the blood serum.
Increased levels are found in hyperthyroidism, acute thyroiditis, and
hepatitis. Low levels can be found in Cretinism, hypothyroidism, cirrhosis,
malnutrition, and chronic thyroiditis. Normal Adult Range: 4 - 12 ug/dl
Optimal Adult Reading: 8 ug/dl
T3-Uptake This test is an indirect measurement of unsaturated thyroxine
binding globulin in the blood. Increased levels are found in hyperthyroidism,
severe liver disease, metastatic malignancy, and pulmonary insufficiency.
Decreased levels are found in hypothyroidism, normal pregnancy, and
hyperestrogenis status. Normal Adult Range: 27 - 47% Optimal Adult Reading:
37 %Free
T4 Index (T7) This index is a calculation used to correct the estimated
total thyroxine for the amount of thyroxine binding globulin present.
It uses the T4 value and the T3 uptake ratio. Normal Adult Range: 4
- 12 Optimal Adult Reading:8
Thyroid-Stimulating Hormone (TSH) TSH, produced by the anterior pituitary
gland, causes the release and distribution of stored thyroid hormones.
When T4 and T3 are too high, TSH secretion decreases, when T4 and T3
are low, TSH secretion increases. Increased TSH levels are seen in primary
hypothyroidism, thyrotropin producing tumors, and thyrotoxicosis. Decreased
levels are seen in hyperthyroidism and secondary and tertiary hypothyroidism.
Normal Adult Range: .5 - 6 miliIU/L Optimal Adult Reading: 3.25 miliU/L
OTHER GLUCOSE (Fasting) Glucose, formed by the digestion of carbohydrates
and the conversion of glycogen by the liver is the primary source of
energy for most cells. Insulin, glucagon, thyroid hormone, liver enzymes
and adrenal hormones regulate it. It is elevated in diabetes, liver
disease, obesity, pancreatitis, steroids, stress, or diet. Low levels
may be indicative of liver disease, overproduction of insulin, hypothyroidism,
or alcoholism. Normal Adult Range: 60 - 115 mg/dl Optimal Adult Reading:
87.5
IRON, TOTAL Iron is necessary for the formation of some proteins,
hemoglobin, myoglobin, and cytochrome. Also it is necessary for oxygen
transport, cellular respiration and peroxide deactivation. Low levels
are seen in many anemias, copper deficiencies, low vitamin C intake,
liver disease, chronic infections, high calcium intake and women with
heavy menstrual flows. High levels are seen in hemochromitosis, liver
damage, pernicious anemia and hemolytic anemia. Normal Adult Range:
30 - 170 mcg/dl Optimal Adult Reading: 100 Disclaimer: Please do not
substitute what you read for competent professional medical advice encompassing
your unique medical condition.
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