- A/G Ratio : The A/G ratio is
the albumin (A) value divided by the globulin (G) value. A low ratio
is found in a variety of disease states related to those of liver or
kidney and to infections and inflammations.
- Albumin : Albumin is the major
protein found in blood making up over 60% of the total protein. Low
levels of albumin occur in malnutrition, chronic inflammation and severe
acute disease and may also manifest with aging. Dehydration caused by
exercise or fluid loss can cause increased serum albumin levels.
- Alkaline Phosphatase : The origin
of this enzyme in the blood of normal adults is primarily from the liver
and bone with a small amount from the intestine. Elevations in the blood
are usually indicative
of liver or bone disease. Children, because of the activity of bone
growth, and pregnant women (third trimester) have significantly higher
- Bilirubin : Bilirubin
is a yellow colored substance that is produced in the body from hemoglobin
and is released when red blood cells disintegrate due to normal aging
or damage. The liver removes the bilirubin from the blood to be excreted
in the bile. A small amount of bilirubin is present
in the blood of normal individuals. Increases in bilirubin are usually
due to liver disease, inflammation (hepatitis), liver failure, obstruction
of the bile duct, or excessive destruction of red blood cells.
- Blood Urea Nitrogen (BUN) :
This waste product from protein metabolism is formed in the liver and
excreted by the kidneys. High BUN values could mean that the kidneys
are not working as well as they should. Low BUN values are less frequent.
They could be due to low protein intake, pregnancy, or severe liver
- BUN/Creatinine Ratio :
This number is obtained by dividing the BUN result by the creatinine
result. It has little significance when the BUN is
normal but can help to determine the cause of high
- Calcium : Calcium is
the most abundant mineral in the body with about 98% found in the skeleton.
The calcium level in the blood is normally maintained within a narrow
range of about 8.5 to 10.8 mg/dL which is critical for many basic processes
such as function of the nervous system and muscles, blood clotting and
many others necessary for life. Excessive secretion of parathyroid hormone
(PTH) is one cause of high blood calcium levels. Other possible
causes for elevated calcium are bone disease and excess dietary
intake of calcium rich foods (milk) or medicines (antacids). Low blood
levels of calcium may lead to tetany (spasms of muscles) and can be
due to malfunction of the parathyroid glands, kidney disease, vitamin
D deficiency and malabsorption caused by disease of the intestine. Either
too high or too low a blood level of calcium can be serious and your
doctor will know best how to manage them.
- Cholesterol : Cholesterol is
a fatty substance necessary for the proper function of every cell in
the body. In the blood, cholesterol is carried in tiny packets encased
by various proteins of which the major forms are the HDL and
the LDL. High levels of total cholesterol are associated with
an increased risk of heart disease caused by thickening of the walls
of the coronary arteries. High cholesterol levels can be reduced by
nutritional supplements, altering the composition of your
diet and by certain medications when diet modifications alone are not
- HDL Cholesterol : This "good"
cholesterol is thought to counteract the effects of LDL cholesterol.
The higher the HDL cholesterol the better. High levels of HDL
cholesterol are associated with lower risk of developing heart disease.
Low levels of HDL are associated with higher risks for heart disease.
There are measures that can be taken to increase HDL cholesterol, such
as regular exercise and losing weight when being overweight. Your doctor
will use the total cholesterol, HDL and LDL cholesterol values to determine
what, if any, measures need to be taken to minimize your risk of heart
- Cholesterol/HDL Ratio : This
ratio is obtained by dividing the cholesterol result by the HDL result.
The higher this number, the greater the risk of developing
coronary heart disease (CHD). Conversely, the lower the ratio the lower
the risk of developing CHD.
- LDL Cholesterol : LDL cholesterol
("bad cholesterol") is the fraction of your cholesterol tht
is implicated in the deposits that thickens the walls of blood vessels.
LDL cholesterol values less than 130 mg/dL are desirable. Values higher
than 160 are associated with a higher risk for heart disease.
: Chloride is one of the electrolytes present in blood. The normal
concentration is maintained in a narrow range. Your doctor interprets
the significance of low or elevated values, in relation to the other
- Creatinine : Creatinine
is a waste product of muscle metabolism. The blood level is determined
by your muscle mass and by the efficiency of the kidneys to excrete
creatinine. High values, especially together with a high BUN, usually
mean kidney disease.
- Globulin : This is the
name of a group of proteins, which comprise the remainder of the total
protein not present as albumin. It is determined by subtracting albumin
from total protein. Low globulin values are
found in certain kidney problems, in hematological disorders, diseases
of the intestine and in other special uncommon conditions. High globulin
is found in many types of inflammation, certain infections and in chronic
: In healthy people the blood level of glucose fluctuates in
response to food intake and fasting within the fairly narrow range of
about 65 to 140 mg/dL. It is therefore important to know whether you
had eaten before your blood was drawn or whether you were fasting for
at least 8-12 hours. The main uses of glucose testing are in the diagnosis
of diabetes mellitus and in the monitoring of treatment and compliance
for this condition. If blood glucose levels fall below the lower normal
limit, the patient may experience symptoms such as weakness, dizziness,
fainting and collapse. This condition is called hypoglycemia. It may
occur in diabetic patients whose food intake and insulin dosage are
not properly balanced and often in otherwise healthy persons.
- Iron : Iron is a critical
part of the hemoglobin molecule found in red blood cells. When the body
iron is low, the person may eventually suffer from decreased hemoglobin.
This is called iron deficiency anemia. Excess iron can be stored in
the liver and in other body organs. A rare, but clinically important,
disease of excess iron storage is called hemochromatosis. Thus, decreased
iron in the blood or increased iron in the blood may be a signal to
your doctor for further diagnostic studies.
- Lactate Dehydrogenase (LDH)
: LDH is an enzyme present in almost all tissues of the body.
Any damaged tissue may leak LDH into the blood and increases above normal
will be observed. These tissues include heart, liver, muscle, kidney,
bone marrow and a variety of tumors. Slight elevations, when other enzymes
are normal, are usually of no clinical significance. Strenuous exercise
including jogging long distances may result in mild increases in blood
- Phosphorus : Phosphorus,
like calcium, is abundant throughout the body with about 85% in the
bones. The level in blood varies over a somewhat wide range as food
intake can significantly alter blood levels. There are many possible
causes for low or high values. The relationship to calcium levels must
be considered in determining the significance of an abnormal phosphorus
- Potassium : The potassium level inside
the cells of the body is about 25 times higher than the level in blood.
The maintenance of this balance is important for many life functions.
Low blood values can occur after prolonged vomiting and diarrhea, in
renal disease and in individuals taking diuretics. Elevated blood potassium
levels may indicate renal disease. Both low and high values are of clinical
significance since potassium is important in the functioning of the
neuromuscular system and especially the muscles of the heart.
- Sodium : This element, present in
body fluids, is the major one of the four "electrolytes" along with
potassium, chloride and bicarbonate. Sodium plays a key role in salt
and water balance. Low sodium values can be found in a variety of conditions
that cause more loss of sodium than water. Some of these conditions
are diarrhea, kidney disease and medication with diuretics. High sodium
values can occur in conditions resulting in excessive loss of water,
e.g. profuse sweating. Your doctor may also evaluate blood sodium levels
as they relate to the other electrolytes.
- Total Proteins
: The plasma proteins serve a number of important functions including
maintenance of normal blood volume and water content in the tissues,
and maintaining normal acid-base balance in the blood. Values below
or above the normal range need further investigation by your doctor
to determine which specific proteins are involved.
- Transaminase SGOT (AST) : This enzyme
has its highest concentrations in heart, liver and muscles. Increased
levels in blood are seen shortly after a heart attack, in liver disease
and diseases involving muscle damage.
- Transaminase SGPT (ALT)
: This enzyme is present in higher concentration in liver than
in muscle. Consequently an elevation is more specific for liver disease.
Both SGOT and SGPT become elevated whenever liver cells are damaged
as, for instance, in viral hepatitis.
- Triglycerides : Triglycerides are
the major form of fat found in nature and are the storage form of fat
in the body. Their primary function is to provide energy. The level
in blood varies widely depending upon the intake of fat and rate of
removal by the tissues of the body. Therefore it is very important to
fast for 12-14 hours to obtain a meaningful measure of the triglyceride
concentration in the blood. High fasting triglyceride levels are associated
with higher risk for coronary heart disease.
- Uric Acid :
Uric acid is a very important antioxidant. It is actually a waste product
of the metabolism of the cells in our bodies. Uric acid is a very important
antioxidant in mammalians, and, together with BUN and creatinine, is
excreted by the kidney. Certain foods such as meat (especially organ
meats) may raise uric acid blood levels. Elevated levels of uric acid
in blood are much more common than are decreased levels. Increased values
are caused by numerous diseases such as gout, kidney failure, diabetes,
and the use of diuretics. Low levels of uric acid may indicate a certain
nutritional deficiency that should be corrected.
- Test Includes: Differential count; hematocrit;
hemoglobin; mean corpuscular volume (MCV); mean corpuscular hemoglobin
(MCH); mean corpuscular hemoglobin concentration (MCHC); percentage
and absolute counts; platelet count; red cell count; white blood cell
count and all tests listed below.
- Use : Evaluate anemia, leukemia, reaction
to inflammation and infections, peripheral blood cellular characteristics,
state of hydration and dehydration, polycythemia, hemolytic disease
of the newborn, inherited disorders of red cells, white cells, and platelets;
manage chemotherapy decisions; determine qualitative and quantitative
variations in white cell numbers and morphology, morphology of red cells
and platelet evaluation.
- In the following a brief explanation is given
of the nine different tests that make up a complete blood count.
- Differential White Blood Cell Count ( "Differential
") : There are five major types of white blood cells: neutrophils,
lymphocytes, monocytes, eosinophils and basophils. The "differential
count" gives the percentages of these five cell types. Increases or
decreases of these individual percentages are characteristic for certain
medical conditions. The determination of these percentages helps your
doctor to arrive at a specific diagnosis.
- Hematocrit (HCT)
: Red blood cells make up about 45% of the volume of whole blood.
This percentage is called the hematocrit. If the number of red cells
is low the hematocrit decreases. Men have somewhat higher hematocrits
than do women. Low hematocrit indicates anemia.
- Hemoglobin (HGB)
: Hemoglobin makes up one third of the mass of each red cell. Hemoglobin
carries oxygen from the lung to the tissues of the body. Since men tend
to have more red cells than do women, men also have higher hemoglobin
levels. Hemoglobin contains iron. A lack of iron due to poor diet or
chronic blood loss often causes anemia. In anemia less hemoglobin is
available to carry oxygen to the tissues which may result in weakness
- Mean Corpuscular Hemoglobin Concentration (MCHC)
: As stated earlier hemoglobin makes up about one third of the mass
of a red cell, ranging normally from 31 to 36%. When not enough hemoglobin
is produced, as for instance in iron deficiency anemia, MCHC values
may fall below 25%.
- Mean Corpuscular Hemoglobin (MCH)
: The weight of hemoglobin in a tiny red blood cell can be calculated.
This calculation is the mean corpuscular hemoglobin (MCH). Certain conclusions
are drawn from normal, low or high values in the diagnosis of anemia.
- Mean Corpuscular Volume (MCV)
: Red blood cells are tiny, round disks of a certain average
size. The volume of these disk-like corpuscles can be measured. In some
types of anemia the MCV is abnormally small and in others abnormally
large. MCV is therefore helpful in characterizing an anemia.
- Platelets :
Blood platelets are even smaller than red cells. The same small droplet
of blood that contains 5 million red cells also contains between 140,000
and 450,000 platelets. Their function is to stop bleeding from injured
small blood vessels as in cuts or abrasions by sticking together and
forming plugs. A variety of disease conditions can cause low numbers
of platelets. Such patients may bleed more easily and excessively. Higher
than normal platelet counts occur in pregnancy or after strenuous exercise.
Increased platelets are noted in more serious conditions such as diseases
of the bone marrow. Platelets do contribute to coronary heart disease
and blood clot formation.
- Red Blood Cell Count (RBC)
: Red blood cells are the major component of your blood. They
cause the red color of blood. One cubic millimeter, a tiny droplet the
size of a pinhead, normally contains about 5 million cells! Men generally
have more red cells than do women. Red cells are made in the bone marrow
and released into the circulating blood. If the number of red cells
drops below the lower normal limit, the condition is called anemia.
There are many causes of anemia. Rarely, some persons may have too many
red cells in their blood, creating a condition called polycythemia.
Both conditions can be treated successfully in most cases.
- White Blood Cell Count (WBC)
: Blood contains a variety of white blood cells. They normally
number between 4,000 and 11,000 per cubic millimeter. Their main function
is defense against infections and purging of areas of injuries and inflammation.
Pus consists mainly of huge numbers of white blood cells. Elevations
of the WBC are seen in many conditions such as infections, injuries,
after surgery, and in other conditions. A mild decrease in WBC frequently
occurs in viral infections. Your doctor will advise you of the significance
of any abnormality of white blood cell counts.
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