# Diagnostic Lab Test Results - Values and What They Mean



## Trouble (Sep 15, 2006)

(modified from posts in another well-known forum, whose mod swiped them from elsewhere)

PART 1 of 3


*LIVER LIPID PANEL*??? Used to determine possible risk for coronary and vascular disease. In other words, heart disease.

*HDL/LDL and Total Cholesterol*: High density/low density lipoprotein ratio and total circulating concentration of cholesterol.  HDL is simply the "good" lipoprotein that acts as a scavenger molecule and prevents a buildup of material. LDL is the "bad" lipoprotein that sticks to arterial walls and causes plaque, eventual blockage or reduction in blood flow. The total cholesterol to HDL ratio is also important. Its an indicator of relative risk of developing cardiovascular disease (CVD).  Low cholesterol values are indicative of severe liver disease (bile acid disease).

HDL  > 35 
LDL  <  130 
total cholesterol/HDL ratio < 3.5. 
VLDL (very low density lipoprotein)  < 30 mg/dl (risk indicator for heart disease).


*Triglycerides*: Triglycerides are simple form of circulating and stored fat, are bound and transported by VLDL and LDL complexes. A high level of triglycerides is also a risk factor for heart disease.  Triglycerides levels can be increased if food or alcohol is consumed 12-24 hrs prior to blood testing - why you're asked to fast for 12-14 hrs from food and avoid alcohol for 24 hours prior to testing. 

Normal Range: 
16-19 yr-old male     40-163 mg/dl
Adult Male               40-160 mg/dl
16-19 yr-old female   40-128 mg/dl
Adult Female            35-135 mg/dl

*Homocysteine*: _always request that this be ordered by the doctor._  Homocysteine is formed in the metabolism of the dietary amino acid methionine and folic acid.  It's a strong risk factor for atherosclerosis.   It is an indicator of improper metabolism of B vitamins (usually from a shortage) or a shortage of methylation equivalents in the liver.  This can easily be corrected by supplementation.  Luckily, taking folic acid (about 400-800 mcg.), use of zinc, vitamin C, smallest doses of B vitamins twice per day and use of TMG (trimethylglycine) and s-adenosylmethionine will help correct this problem and avoid liver damage.  It wil also help address low cholesterol readings, when coupled with other supplements.

Normal ranges:
Males and Females age 0-30         4.6-8.1 umol/L
Males age 30-59                         6.3-11.2 umol/L
Females age 30-59                      4.5-7.9 umol/L
>59 years of age                         5.8-11.9 umol/L


*Blood Cell Tests*: These are various tests that examine a number of components of your blood and look for any abnormalities that could be indicative of serious diseases.

*WBC Total *(White Blood Cell): Also referred to as leukocytes, a fluctuation in the number of these types of cells may indicate the presence of infections and disease states dealing with impaired immune system status (cancer, excess stress/catabolism)

Normal range:  4,500-11,000/mm3

*Neutrophils*: This is one type of white blood cell that's in circulation for only a very short time. Essentially their job is phagocytosis,  trapping and disposing of bacterial pathogens. Both severe trauma and bacterial infections, as well as inflammatory or metabolic disorders and even stress, can cause an increase in the number of these cells. Having a low number of neutrophils can be indicative of a viral infection, a bacterial infection, or a rotten diet.

Normal range:  2,500-8,000 cells per mm3


*RBC *(Red Blood Cell): called erythrocytes, their primary function is to carry oxygen (via the hemoglobin contained in each RBC) to various tissues as well as giving our blood that cool "red" color. RBC survive in peripheral blood circulation for approximately 120 days. A decrease in the number of these cells can result in anemia which could stem from dietary insufficiencies. An increase in number can occur when androgens are used. This is because androgens increase EPO (erythropoietin) production and red blood cell division, increasing RBC count. This can increase blood pressure and result in stroke (called a cardiovascular accident, or CVA).

Normal ranges:
Adult Male       4,700,000-6,100,000 cells/uL
Adult Female    4,200,000-5,400,000 cells/uL


*Hemoglobin*:  Hemoglobin is a carrier of dissolved gases, oxygen and carbon dioxide, in blood, an important part of each red blood cell surface.  An increase in hemoglobin can be an indicator of congenital heart disease, congestive heart failure, sever burns, or dehydration. Being at high altitudes, or the use of androgens, can cause an increase as well. A decrease in number can be a sign of anemia, lymphoma, kidney disease, sever hemorrhage, cancer, sickle cell anemia, etc.

Normal ranges:
Youngsters/Adolescents:  10-15.5 g/dl
Adult Males                    14-18 g/dl
Adult Females                 12-16 g/dl


*Hematocrit*:  The hematocrit is used to measure the percentage of the total blood volume that's made up of red blood cells. An increase in percentage may be indicative of congenital heart disease, dehydration, diarrhea, burns, etc.  A decrease may be indicative of anemia, hyperthyroidism, cirrhosis, hemorrhage, leukemia, rheumatoid arthritis, pregnancy, malnutrition, a sucking knife wound to the chest, etc.

Normal ranges:
Youngesters and Adolescents:  32-44%
Adult Men                             42-52%
Adult Women                         37-47%


*MCV* (Mean Corpuscular Volume): This is one of three red blood cell indices used to check for abnormalities. The MCV is the size or volume of the average red blood cell. A decrease in MCV would then indicate that the RBC's are abnormally large(or macrocytic), and this may be an indicator of iron deficiency anemia or thalassemia. When an increase is noted, that would indicate abnormally small RBC (microcytic), and this may be indicative of a vitamin B12 or folic acid deficiency as well as liver disease.

Normal ranges:
Adult Male        80-100 fL
Adult Female    79-98 fL
Adolescent       78-100 fL


*MCH *(Mean Corpuscular Hemoglobin): The MCH is the weight of hemoglobin present in the average red blood cell. This is yet another way to assess whether some sort of anemia or deficiency is present.

Normal ranges:
Adolescent:     35-45 pg
Adult Male       26-34 pg
Adult Female    26-34 pg


*MCHC* (Mean Corpuscular Hemoglobin Concentration): The MCHC is the measurement of the amount of hemoglobin present in the average red blood cell as compared to its size. A decrease in number is an indicator of iron deficiency, thalassemia, lead poisoning, etc. An increase is sometimes seen after androgen use.

Normal ranges:
Adolescent:     31-37 g/dl
Adult Male       31-37 g/dl
Adult Female    30-36 g/dl

*RDW* (Red Cell Distribution Width): The RDW is an indicator of the variation in red blood cell size. It's used in order to help classify certain types of anemia, and to see if some of the red blood cells need their suits tailored. An increase in RDW can be indicative of iron deficiency anemia, vitamin B12 or folate deficiency anemia, and diseases like sickle cell anemia.

Normal ranges:
Adult Male        11.7-14.2%
Adult Female     11.7-14.2%


*Platelets*:  Platelets or thrombocytes are essential for your body's ability to form blood clots and thus stop bleeding. They're measured in order to assess the likelihood of certain disorders or diseases. An increase can be indicative of a malignant disorder, rheumatoid arthritis, iron deficiency anemia, etc. A decrease may be caused by infection, various types of anemia, leukemia, etc.

Normal Range for Adults:
150,000-400,000/mm3  (Or 150-400 x 10(9th)/L)
Anything above 1 million/mm3 would be considered a critical value and should be evaluated by a blood specialist (hematologist). 


*ABS* (Differential Blood Cell Type Counts): The differential count measures the percentage of each type of leukocyte or white blood cell present in the same specimen. Using this, they can determine whether there's a bacterial or parasitic infection, as well as immune reactions, etc.

*Neutrophils*: Severe trauma, stress and bacterial infections, as well as inflammatory disorders, metabolic disorders can cause an increase in the neutrophil count. A low number can indicate a viral infection, a bacterial infection, or a deficient diet.

Normal Percentile Range:55-70%


*Basophils*:  Both basolphils and eosinophils are present in an allergic reaction and parasite infection. These types of cells don't increase in response to viral or bacterial infections, so if an increased count is noted, it can be deduced that either an allergic response has occurred or a zoophilic pathogen infection is present.  

Normal Percentile Range: 
Basophils            0.5-1.0 %
Eosinophils          1.0-4.0 %


*Lymphocytes and Monocytes*: Lymphocytes can be divided in to two different types of cells: T cells and B cells. T cells are involved in immune reactions and B cells are involved in antibody production. The main job of lymphocytes in general is to fight off ??? Bruce Lee style ??? bacterial and viral infections.  Monocytes are similar to neutrophils but are produced more rapidly and stay in the system for a longer period of time.

Normal Percentile Range:
Lymphocytes                  20-40 %
Monocytes                       2-8 %


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## Trouble (Sep 15, 2006)

*Part 2 of 3*

*Selected Clinical Values of Electrolytes and Other Analytes*


*Sodium*: This cation (an ion with a postive charge) is mainly found in extracellular spaces and is responsible for maintaining a balance of water in the body.  When plasma sodium  rises, the kidneys conserve water. Conversely, when the sodium concentration is low, the kidneys conserve sodium and excrete water. 

Increased levels can result from excessive dietary intake, Cushing's syndrome, excessive sweating, severe burns, and prolonged dehydration. Decreased levels can result from a deficient diet, Addison's disease, diarrhea, vomiting, chronic renal insufficiency, excessive water intake, and congestive heart failure. Anabolic steroids will result in an increased level of sodium as well.

Normal Adult Range:  136-145 mEq/L


*Potassium*: Potassium in an extremely important intracellular cation, responsible for nerve condition and ion balance across membranes.  Increased levels can result from excessive dietary intake, acute renal failure, aldosterone-inhibiting diuretics, a crushing injury to tissues, infection, acidosis, and chronic or prolonged dehydration.  Decreased levels can be indicative of a deficient dietary intake, burns, diarrhea or vomiting, diuretics, Cushing's syndrome, licorice consumption, insulin use, cystic fibrosis, trauma, and surgery.

Normal Adult Range:   3.5-5 mEq/L


*Chloride*: This is the major extracellular anion (an ion carrying a negative charge). Its purpose it is to maintain electrical neutrality with sodium. It also serves as a buffer in order to maintain the pH balance of the blood. Chloride typically accompanies sodium and thus the causes for change are essentially the same.

Normal Adult range:   98-106 mEq/L


*Calcium:* Calcium is measured in order to assess the function of the parathyroid and calcium metabolism. Increased levels can stem from hyperparathyroidism, metastatic tumor to the bone, prolonged immobilization, lymphoma, hyperthyroidism, acromegaly, etc. It's also important to note that anabolic steroids can also increase calcium levels. Decreased levels can stem from renal failure, rickets, vitamin D deficiency, malabsorption, pancreatitis, and alkalosis.

Normal  Adult range:  9-10.5 mg/dl


*Carbon Dioxide*:  Dissolved carbon dioxide, CO2,  is used to evaluate the pH (relative acidity) of the blood as well as aid in evaluation of electrolyte levels. Increased levels can be indicative of severe diarrhea, starvation, vomiting, emphysema, metabolic alkalosis, etc. Increased levels could also mean that you're a plant. Decreased levels can be indicative of kidney failure, metabolic acidosis, shock, and starvation.

Normal Adult range:   23-30 mEq/L


*Glucose*: The amount of glucose in the blood after a prolonged period of fasting (12-14 hours) is used to determine whether a person is in a hypoglycemic (low blood glucose) or hyperglycemic (high blood glucose) state. Both can be indicators of serious conditions.  Elevated blood glucose readings (hyperglycemia) can be indicative of diabetes, acute stress, Cushing's syndrome, chronic renal failure, corticosteroid therapy, acromegaly, and other disease.  Decreased levels could be indicative of hypothyroidism, insulinoma (tumor of the beta islet cells of the pancreas), liver disease, insulin overdose, and starvation.

Normal range:    80-120 mg/dL
Low normal:       65-80  mg/dL


*BUN (Blood Urea Nitrogen)*: This test measures the amount of urea nitrogen that's present in the blood. When protein is metabolized, the end product is urea which is formed in the liver and excreted from the bloodstream via the kidneys. This is why BUN is a good indicator of both liver and kidney function. Increased levels can stem from shock, burns, dehydration, congestive hear failure, myocardial infarction, excessive protein ingestion, excessive protein catabolism, starvation, sepsis, renal disease, renal failure, etc. Causes of a decrease in levels can be liver failure, overhydration, negative nitrogen balance via malnutrition, pregnancy, etc.

Normal range:  10-20 mg/dl


*Creatinine*: Creatinine is a byproduct of creatine phosphate, the chemical used in contraction of skeletal muscle. So, the more muscle mass you have, the higher the creatine levels and therefore the higher the levels of creatinine.  When you ingest large amounts of meat proteins that have high levels of creatine in them, you can increase creatinine levels as well. Since creatinine levels are used to measure the functioning of the kidneys, this easily explains why creatine has been accused of causing kidney damage, since it naturally results in an increase in creatinine levels.

However, we need to remember that these tests are only indicators of functioning and thus outside drugs and supplements can influence them and give false results, as creatine may do. This is why creatine, while increasing creatinine levels, does not cause renal damage or impair function. Generally speaking, though, increased levels are indicative of urinary tract obstruction, acute tubular necrosis, reduced renal blood flow (stemming from shock, dehydration, congestive heart failure, atherosclerosis), as well as acromegaly. Decreased levels can be indicative of debilitation, muscle wasting, cancer, and lost muscle mass via disease or extreme stress (including thermal heat shock and dehydration).

Normal range:
Adult Male         0.6-1.2 mg/dl
Adult Female      0.5-1.1 mg/dl


*BUN/Creatinine Ratio*: A high ratio may be found in states of shock, volume depletion, hypotension, dehydration, gastrointestinal bleeding, and in some cases, a catabolic state. A low ratio can be indicative of a low protein diet, malnutrition, pregnancy, severe liver disease, ketosis, etc. It is important to note that a high protein diet will result in a higher BUN/creatinine ratio - makes sure your physician and lab clinicians are aware of this fact.

Normal range:  6-25  (unitless measure)


*Liver Function Assays*

*Total Protein and Globulins*: A measure of the total level of albumin and globulin in the body. Albumin is synthesized by the liver and as such is used as an indicator of liver function. It functions to transport hormones, enzymes, drugs and other constituents of the blood.

Globulins are the building blocks of your body's antibodies. Measuring the levels of these two proteins is also an indicator of nutritional status. Increased albumin levels can result from dehydration, while decreased albumin levels can result from malnutrition, pregnancy, liver disease, overhydration, inflammatory diseases, etc. 

Increased globulin levels can result from inflammatory diseases, hypercholesterolemia (high cholesterol), iron deficiency anemia, as well as infections. Decreased globulin levels can result from hyperthyroidism, liver dysfunction, malnutrition, and immune deficiencies or disorders.

As another important side note, anabolic steroids, growth hormone, and insulin can all increase serum protein concentrations.

Normal Adult range:
Total Protein:        6.4-8.3 g/dl
Albumin:               3.5-5.0 g/dl
Globulin:               2.3-3.4 g/dl
Albumin/Globulin Ratio:  0.8-2.0


*Bilirubin*: Bilirubin is one of the many constituents of bile, which is formed in the liver. An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation. Drugs that may increase bilirubin include oral anabolic steroids (17-AA), antibiotics, diuretics, morphine, codeine, contraceptives, etc. Drugs that may decrease levels are barbiturates and caffeine. Non-drug induced increased levels can be indicative of gallstones, extensive liver metastasis, and cholestasis from certain drugs, hepatitis, sepsis, sickle cell anemia, cirrhosis, etc.

Normal Adult range:  0.3-1.0 mg/dl


*Alkaline Phosphatase*:  This important liver enzyme is used as an indicator of liver stress or damage. Increased levels can stem from cirrhosis, liver tumor, pregnancy, healing fracture, normal bones of growing children, and rheumatoid arthritis. Decreased levels can stem from hypothyroidism, malnutrition, pernicious anemia, scurvy (vitamin C deficiency) and excess vitamin B ingestion. As a side note, antibiotics can cause an increase in the enzyme levels.

Normal range:
Adolescent      30-200 U/L
Adult              30-120 U/L


*AST* (Aspartate Aminotransferase, SGOT): This is yet another enzyme that's used to determine if there's damage or stress to the liver, as well as for the presence of heart disease.  When the liver is damaged or inflamed, AST levels can rise to a very high level (20 times the normal value). This happens because AST is released when the cells of that particular organ (liver) rupture from chemical injury. The AST then enters blood circulation. Increased levels can be indicative of heart disease, liver disease, skeletal muscle disease or injuries, as well as heat stroke. Decreased levels can be indicative of acute kidney disease, beriberi, diabetic ketoacidosis, pregnancy, and renal dialysis.

Normal Adult Range: 0-35 U/L (Females may have slightly lower levels)


*ALT *(Alanine Aminotransferase, SGPT): This is yet another enzyme that is found in high levels within the liver. Injury or disease of the liver will result in an increase in levels of ALT.  Smaller quantities are also found in skeletal muscle, so there can be a weight-training induced increase thru DOMS/resistance training damage to muscle tissue, giving a false indicator for liver disease.  Increased levels can be indicative of hepatitis, hepatic necrosis, cirrhosis, cholestasis, hepatic tumor, hepatotoxic drugs, and jaundice, as well as severe burns, trauma to striated muscle (via weight training), myocardial infarction, mononucleosis, and shock.

Normal Adult Range:   4-36 U/L


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## Trouble (Sep 15, 2006)

*Part 3 of 3*

I'll be amending this section, well beyond the information provided here.  This is a stop gap post.


*Endocrine Function*
*
Testosterone (Free and Total)*  About 95% of the circulating Testosterone in a man's body is formed by the Leydig cells, which are found in the testicles. Women also have a small amount of Testosterone in their body as well. This is from a very small amount of Testosterone secreted by the ovaries and the adrenal gland (in which the majority is made from the adrenal conversion of androstenedione to Testosterone via 17-beta HSD).

Nomal range, total Testosterone:

Male 
Age 14          <1200 ng/dl
Age 15-16    100-1200 ng/dl
Age 17-18    300-1200 ng/dl
Age 19-40    300-950 ng/dl
Over 40       240-950 ng/dl

Female
Age 17-18    20-120 ng/dl
Over 18       20-80 ng/dl

Normal range, free Testosterone:
Male          50-210 pg/ml


*LH* (Luteinizing Hormone)  LH is a glycoprotein that's secreted by the anterior pituitary gland and is responsible for signaling Leydig cells to produce testosterone.  Measuring LH can be very useful in terms of determining whether a hypogonadal state (low testosterone) is caused by the testes not being responsive despite high or normal LH levels (primary), or whether it's the pituitary gland not secreting enough LH (secondary). Another possibility is that the anterior pituitary under the direciton of the hypothalamus??? which secretes LH-RH (luteinizing hormone releasing hormone) ??? maybe dynfunctional.

If it's a case of the testes not being responsive to LH, then compounds like clomiphene and hCG really won't help. If the problem is secondary, then there's a better chance for improvement with drug therapy. Increased levels can be indicative of hypogonadism, precocious puberty, and pituitary adenoma. Decreased levels can be indicative of pituitary failure, hypothalamic failure, stress, and malnutrition.

Normal ranges:

Adult Male             1.24-7.8 IU/L

Adult Female
Follicular phase:     1.68-15 IU/L
Ovulatory phase:   21.9-56.6 IU/L
Luteal phase:        0.61-16.3 IU/L
Postmenopausal:  14.2-52.3 IU/L


*Estradiol*  An excess of this hormone is known to be responsible for symptoms such as  water retention, hypertrophy of adipose tissue, gynecomastia, and may play a role in the development of prostate hyperplasty and tumor formation in the prostate and breast in males.  Estrogen is the primary hormone responsible for the negative feedback loop which suppresses endogenous testosterone production. Increased estradiol levels can be indicative of a testicular tumor, adrenal tumor, hepatic cirrhosis, necrosis of the liver, hyperthyroidism, etc.

Normal ranges:

Adult Male            10-50 pg/ml

Adult Female
Follicular phase:    20-350 pg/ml
Midcycle peak:     150-750 pg/ml
Luteal phase:         0-450 pg/ml
Postmenopausal:    < 20 pg/ml 

*
Thyroid Hormone Panel *(T3, T4 Total and Free, TSH)

*T3* (Triiodothyronine) T3 is the more metabolically active hormone out of T4 and T3. When levels are below normal it's generally safe to assume that the individual is suffering from hypothyroidism. Drugs that may increase T3 levels include estrogen and oral contraceptives. Drugs that may decrease T3 levels include anabolic steroids/androgens as well as propanolol (a beta adrenergic blocker) and high dosages of salicylates. Increased levels can be indicative of Graves disease, acute thyroiditis, pregnancy, hepatitis, etc. Decreased levels can be indicative of hypothyroidism, protein malnutrition, kidney failure, Cushing's syndrome, cirrhosis, and liver diseases.

Normal ranges:

16-20 years old     80-210 ng/dl
20-50 years         75-220 ng/dl   (or 1.2-3.4 nmol/L)
> 50 yrs old         40-180 ng/dl    (or 0.6-2.8 nmol/L)


*T4* (Thyroxine) T4 is indicator of whether or not someone is in a hypo- or hyper-thyroid state. It too is rather reliable but free thyroxine levels should be assessed as well.  Drugs that increase of decrease T3 will, in most cases, do the same with T4. Increased levels are indicative of the same conditions as T3 and a decrease can be indicative of protein depleted states, iodine insufficiency, kidney failure, Cushing's syndrome, and cirrhosis.

Normal ranges:
Adult Male         4-12 ug/dl or 51-154 nmol/L
Adult Female      5-12 ug/dl or 64-154 nmol/L


*Free T4 *or Thyroxine:  Since only 1-5% of the total amount of T4 is actually free and useable, this test is a far better indicator of the thyroid status of the patient. An increase indicates a hyperthyroid state and a decrease indicates a hypothyroid state.  Drugs that increase free T4 are heparin, aspirin, danazol, and propanolol.  Drugs that decrease it are furosemide, methadone, and rifampicin.  Increased and decreased levels are indicative of the same possible diseases and states that are seen with T4 and T3.

Normal range: 0.8-2.8 ng/dl or 10-36 pmol/L


*TSH *(Thyroid Stimulating Hormone): Measuring the level of TSH can be very helpful in terms of determining if hormoone problem resides with the thyroid itself (primary) or the pituitary gland (secondary). If TSH levels are high, then it's merely the thyroid gland not responding for some reason but if TSH levels are low, it's the hypothalamus or pituitary gland that has something wrong with it. The problem could be a tumor, some type of trauma or immune response.

Drugs that can increase levels of TSH include lithium, potassium iodide and TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine, T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and congenital cretinism. Decreased levels are indicative of hypothyroidism (pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.

Normal Adult Range:  2-10 uU/ml or 2-10 mU/L


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