Learn More about each Biomarker…
Significance of blood test results
A blood test is a laboratory examination of a blood sample used to check for a wide variety of health conditions, including organ function (such as the heart, liver, kidneys, and thyroid), infections, diseases, and one’s general health.
Most blood tests contain three main components: a complete blood count (CBC), a comprehensive metabolic panel (CMP), and a lipid panel. Each tests for different things and organ functionality. Detailed analyses of the blood test results provide deeper explanation of these areas.
On most laboratory test results, one will find a “Reference Range” or “Normal Range.” This range is what’s considered normal in mainstream medicine. That range is based on a bell curve – a statistical average of the population of that particular lab. People who go to labs are typically sick people, so if the result comes back within that reference range, it does not automatically mean it’s at the optimal functional level for each person.
Please note that normal ranges can vary due to lab-specific differences in equipment, techniques, and chemicals used.
Complete blood count (CBC)
The complete blood count (CBC) measures the total volume of blood cells, enables analysis of an individual’s overall health, and provides indications for underlying health conditions such as blood cancers, leukemia and anemia.
The complete blood count (CBC) provides information on all three types of blood cells: white blood cells (WBCs), red blood cells (RBCs) and platelets.
The subsets within the CBC are:
White blood cells, which are also called leukocytes, are a major part of our body’s immune system and produced to address infections. As such, a high white blood cell count can indicate an infection or high levels of chronic inflammation. Conversely, a low white blood cell count can indicate a variety of health conditions, such as HIV/AIDS and autoimmune diseases such as lupus. The Normal range is: 4,500–11,000 / mm3
There are five main components of white blood cells. Labs assess their volume and relative proportions. When one has an infection or a medical condition, then the relative proportions can be askew. Healthy proportions for each component are:
Neutrophils: 40 – 60 % of the total
Lymphocytes: 20 – 40 %
Monocytes: 2 – 8 %
Eosinophiles: 1 – 4 %
Basophils: 0.5 – 1 %
Neutrophils are the first immune cells to respond to invading toxic particles and pathogenic microorganisms, such as bacteria, virus, parasites, and fungi, by trapping them and releasing enzymes that kill them. Neutrophils produced from the spleen stimulate antibody production to prevent future pathogenic microorganisms from causing infections. Neutrophils also boost the response of other immune cells.
An abnormally low neutrophil count, also called neutropenia, indicates that the spleen is not working properly and unable to provide an appropriate immune response when exposed to pathogenic microorganisms, thus increasing the likelihood of infections. It is also linked to a severe imbalance in the gut microbiome which may enable an infection from normal bacteria in and on the body.
An abnormally high neutrophil count, also called leukocytosis, indicates that there are too many neutrophils in the bloodstream. It can be associated with an active infection, extremely high levels of inflammation in the bloodstream, recurring infections, and cancer.
Lymphocytes (sometimes shortened to Lymphs) include natural killer cells (also referred to as NK cells), T cells, and B cells, and are the main cells found in lymph, which is the fluid in the lymphatic system. Lymphocytes identify invaders, such as viruses or bacteria, and cells infected by pathogens, and generate powerful enzymes or antibodies to destroy pathogens or pathogen-infected cells.
Following activation addressing invaders, T cells and B cells remember each specific pathogen encountered and then mount a rapid response if the same pathogen is detected again. Natural Killer (NK) cells attack and kill cells infected by viruses or cancer. They modulate the functions of other immune cells and distinguish between normal and infected cells. NK cells are activated in response to a family of cytokines, called interferons.
An abnormally high lymphocyte concentration can be a sign of an infection, more likely viral than bacterial, and in rare cases, blood cancers (i.e. leukemia or lymphoma). An abnormally low lymphocyte concentration indicates that the immune system is compromised and there’s a higher risk of infections and even microscopic cancer cell growth. It is associated with a dysfunctional gut, spleen, lymphatic system, and/or bone marrow.
While made in the bone marrow, monocytes transform into macrophage or dendritic cells and attack invaders, ingest foreign material, remove dead cells, and facilitate healing and repair.
An abnormally low monocyte count indicates that the immune system is compromised and there’s a higher risk of infections. An abnormally high monocyte count is often associated with chronic infection, chronic inflammation and also linked to cancer.
Eosinophils (sometimes shortened to Eos) are crucial for fighting disease and are linked with allergic reactions, certain infections and inflammatory response, such as in the gut and lungs. Other roles include killing abnormal cells, regulating glucose metabolism in fat tissues, and supporting tissue repair. While produced in the bone marrow, eosinophils then travel to different tissues throughout the body.
An abnormally high eosinophil count indicates an underlying food allergy, other allergic reaction, infection, or – in rare cases – cancer. Most people with abnormally high eosinophil counts, which is called eosinophilia, complain of severe muscle aches with possible joint pain, weakness, fatigue, difficulty breathing, cough, rash, headache, peripheral edema (swelling), fever and abnormal tingling sensations.
An abnormally low eosinophil count can be the result of intoxication from alcohol or excessive production of steroids like the stress hormone cortisol.
Red blood cells (RBCs) carry oxygen to tissues and organs, making it critical to their health and function. A RBC count estimates the total volume of RBCs inside the body. The RBC count represents the ability of bone marrow to make RBCs and the kidneys’ ability to produce erythropoietin (EPO), an essential building block for RBCs. It also represents the stomach’s ability to absorb nutrients, such as iron, Vitamin B-12, and folate, necessary for binding oxygen to the RBCs. When the RBC count results are outside normal parameters, they can indicate various medical conditions.
Normal range:
- Male: 4.3 – 5.9 million/mm3
- Female: 3.5 – 5.5 million/mm3
Hemoglobin is a protein in RBCs that carries oxygen from the lungs to the body’s organs and tissues and transports carbon dioxide from organs and tissues back to the lungs.
The healthy range for hemoglobin is:
For men, 14.0 – 17.5 g/dL (grams per deciliter)
For women, 12.3 – 15.3 g/dL (grams per deciliter)
For children, healthy ranges vary with age and sex.
If hemoglobin levels are lower than normal, it indicates a low RBC count, or anemia. Anemia has many forms and corresponding root causes, including, but not limited to, iron deficiency, vitamin B-12 deficiency, folate deficiency, kidney disease, liver disease, hypothyroidism, excessive bleeding, and cancers such as leukemia that affect bone marrow. If hemoglobin levels are higher than normal, its causes can include dehydration, smoking, lung disease, living at high altitudes, rigorous physical exercise, and possibly blood disorders, such as polycythemia vera.
The hematocrit test, also known as the packed-cell volume (PCV) test, measures the proportion of one’s blood that is composed of red blood cells (RBCs). The Hct test can help physicians make a diagnosis or monitor responses to treatments.
Normal range:
- Male: 41–53%
- Female: 36–46%
A lower than normal hematocrit can indicate:
- An insufficiently low number of healthy RBCs, indicating anemia
- Vitamin or mineral deficiencies, possibly from stomach or gut dysfunction
- A large number of white blood cells due to long-term illness, infection, inflammation, or a white blood cell disorder (e.g. leukemia or lymphoma)
- Blood loss, either short-term or long-term
A higher than normal hematocrit can indicate:
- Dehydration
- Heart disease
- Lung disease
- A health issue that causes the body to produce too many red blood cells (e.g. polycythemia vera)
The average volume of RBCs, or the space each red blood cell fills, is measured through the mean corpuscular volume (MCV) test. MCV is calculated by dividing the hematocrit (Hct) by the concentration of RBCs. MCV = Hct / [RBC] MCV is typically expressed in femtoliters (fL, or 10−15 L), and [RBC] in millions per microliter (106 / μL).
The normal range for MCV is 80–100 fL. An abnormally low MCV value can be an indication of intracellular iron deficiency. Conversely, an abnormally high MCV value can be an indication of folate and/or Vitamin B-12 deficiencies and possible other B vitamin deficiencies. These deficiencies are often correlated with digestive disorders (typically in the stomach), suboptimal lung function with a tendency for shallow breath, and an overworked sympathetic nervous system. Abnormal results can also be an indication of chronic fatigue syndrome, anemia, and other medical conditions.
The average volume of RBCs, or the space each red blood cell fills, is measured through the mean corpuscular volume (MCV) test. MCV is calculated by dividing the hematocrit (Hct) by the concentration of RBCs. MCV = Hct / [RBC] MCV is typically expressed in femtoliters (fL, or 10−15 L), and [RBC] in millions per microliter (106 / μL).
The normal range for MCV is 80–100 fL. An abnormally low MCV value can be an indication of intracellular iron deficiency. Conversely, an abnormally high MCV value can be an indication of folate and/or Vitamin B-12 deficiencies and possible other B vitamin deficiencies. These deficiencies are often correlated with digestive disorders (typically in the stomach), suboptimal lung function with a tendency for shallow breath, and an overworked sympathetic nervous system. Abnormal results can also be an indication of chronic fatigue syndrome, anemia, and other medical conditions.
The average mass of hemoglobin present in each red blood cell in a blood sample is the mean corpuscular hemoglobin (MCH). MCH is calculated by dividing the total mass of hemoglobin by the number of red blood cells in a sample of blood. MCH = (Hb*10) / RBC. A normal MCH value is 27 – 31 picograms (pg)/cell. Abnormally low levels are a possible sign of malnutrition and high levels can be an indicator of anemia.
The mean corpuscular hemoglobin concentration (MCHC) is a measure of the concentration of hemoglobin in a volume of red blood cells. It is derived by dividing the hemoglobin by the hematocrit. The normal range is 31.5-35.7 g/dL, or 4.8 – 5.58 mmol/L.
An abnormally low MCHC value can be interpreted as a decreased production of hemoglobin. Given how it is calculated, MCHC can be normal even when hemoglobin production is decreased, such as in cases of iron deficiency. An abnormally high MCHC are possible signs of hereditary spherocytosis, sickle cell disease, homozygous hemoglobin C disease, and some megaloblastic anemias.
Red blood cell distribution width (RDW, RDW-CV, RCDW, or RDW-SD) measures the range of distribution of RBC volumes (not their cell sizes). Higher RDW values indicate greater variations in size. Normal human reference range of RDW-CV is 11.5% – 15.4%. Levels outside of the normal range can indicate conditions such as anemia, malnutrition and liver disease.
Platelets are small cells that help the blood to clot. The platelet count test measures the number of platelets present in blood. If testing highlights a high count, this can indicate infection, anemia, or cancer, while a low count can prevent bleeding from stopping and wounds from healing. Its normal range is 150,000–400,000/mm3 or 200 – 500 x103/uL.
Mean platelet volume (MPV) is a measure of the volume of platelets in one’s blood. An unusually high platelet volume can indicate higher risks of cardiac events, such as heart attacks and strokes, while a low platelet volume can cause irregularities with bleeding.
Comprehensive metabolic panel (CMP)
The complete blood count (CBC) measures the total volume of blood cells, enables analysis of an individual’s overall health, and provides indications for underlying health conditions such as blood cancers, leukemia and anemia.
The complete blood count (CBC) provides information on all three types of blood cells: white blood cells (WBCs), red blood cells (RBCs) and platelets.
The subsets within the CBC are:
The blood urea nitrogen (BUN) test reveals how efficiently the body’s bacteria metabolizes atmospheric nitrogen used to form amino acids (building blocks of protein) and energy (also referred to as adenosine triphosphate or ATP). Because excess nitrogen is toxic and cannot be accumulated in the body, it is disposed by the following process:
- Liver cells convert excess nitrogen to ammonia.
- Ammonia combines with other elements, such as carbon, hydrogen and oxygen, to form urea, a chemical waste product.
- The urea is released from liver cells into the bloodstream and transported to the kidneys.
- Healthy kidneys filter the blood and remove urea along with other waste products out of the body in the form of urine.
A BUN test measures the amount of urea nitrogen that’s in the blood (that’s why it may be referred to as BUN, serum or plasma). Outside the United States, “Urea” is often measured instead of BUN, as BUN only reflects the nitrogen content of urea while urea reflects the whole molecule. The urea is approximately twice (specifically 2.14) that of BUN.
A BUN test can reveal whether one’s urea nitrogen levels are higher than normal, suggesting that the kidneys and the pathways noted above linked to protein metabolism are not working properly.
The normal range of blood urea nitrogen is 5 to 20 mg/dl, or 1.8 to 7.1 mmol urea per liter. The range is wide because of normal variations in protein intake, its breakdown in the gut, and how efficiently the liver and kidneys dispose of toxic protein byproducts, such as nitrogen, in the form of urine.
Creatinine (Cr) is a chemical waste molecule that is important for creating muscle energy. Increased levels of creatinine can be an indication of kidney dysfunction. Each kidney has millions of small blood-filtering units called nephrons. The nephrons constantly filter blood through tiny clusters of blood vessels known as glomeruli. These structures filter waste products, excess water, and other impurities out of the blood. The toxins are then stored in the bladder and removed during urination.
Creatinine is one of the substances that the kidneys normally eliminate from the body. By measuring the level of creatinine in the blood, one can assess how well the kidneys are functioning. High levels of creatinine may indicate that the kidneys are damaged and not working properly.
Normal range:
- Men aged 18-60: 0.9–1.3 mg/dL
- Men age 60+: 0.8–1.3 mg/dL
- Women aged 18-60: 0.6–1.1 mg/dL
- Women age 60+: 0.6–1.2 mg/dL
The BUN-to-creatinine ratio is the ratio of the blood urea nitrogen (BUN) and creatinine (Cr). Outside the United States, the urea-to-creatinine ratio is often calculated instead. The principle behind these ratios is the fact that both urea (BUN) and creatinine are freely filtered by the glomerulus; however, urea reabsorbed by the tubules can be regulated (increased or decreased) whereas creatinine reabsorption remains the same (minimal reabsorption). Thus, the ratio may be used to determine the cause of acute kidney injury or dehydration.
The Albumin-to-creatinine ratio (ACR), also known as urine microalbumin, compares the amount of albumin in the blood to the amount of creatinine. Healthy kidneys filter waste from blood and retain the healthy components, including proteins such as albumin. Kidney damage can cause proteins to leak through the kidneys and exit the body in urine. Albumin is one of the first proteins to leak when kidneys become damaged. ACR or microalbumin test is used to detect early signs of kidney damage in people who are at risk of developing kidney disease, such as those with diabetes, prediabetes or high blood pressure. A normal ratio in adults is less than 30 mg/g creatinine.
Sodium is a mineral that aids nerve impulses and muscle contractions, as well as balances water levels. Normal range for adults 18 to 90 years old is 136–145 mEq/L. Abnormal levels are a possible indication of dehydration, adrenal gland disorders (e.g. Addison’s disease), corticosteroids, and kidney, liver, or heart disorders.
The chloride blood test, or serum chloride level, measures the body’s chloride levels. Chloride is an electrolyte that helps keep appropriate fluid and acid-base balance in the body. Normal range for adults 18 to 90 years old is 98–107 mEq/L. Abnormal blood chloride levels lead to health conditions, such as alkalosis, which happens when the blood is either too alkaline or basic, and acidosis, which happens when the blood is too acidic. Abnormal levels of chloride can indicate dehydration as well as kidney disorders, liver issues, and adrenal gland dysfunction.
Chloride test results are most accurate when one does not drink or eat anything for eight hours leading up to the test. One should also avoid taking hormones, nonsteroidal anti-inflammatory drugs (NSAIDs), and diuretics, as they can affect the test results.
Carbon dioxide (CO2) is a waste product created by the body, transported via blood to the lungs, and exhaled. The CO2 blood test is part of an electrolyte panel, since electrolytes help balance the levels of acids and bases in the body. The test may help diagnose or monitor conditions related to electrolyte imbalance.
Abnormally high levels reflect too many bases in the blood, called alkalosis, and can indicate kidney disorders, lung diseases, adrenal glands dysfunction (e.g. Cushing’s syndrome), and hormonal disorders. Abnormally low levels reflect too many acids in the blood, called acidosis, and can indicate kidney disorders, adrenal glands dysfunction (e.g. Addison’s disease), ketoacidosis (a complication of diabetes) and shock. Please note that certain over-the-counter and prescription medicines can affect the level of CO2 in the blood
The total protein test measures the total amount of protein in the blood. There are two major types of protein in the blood: Albumin and Globulin. Albumin is produced in the liver and helps keep blood from leaking out of blood vessels and move minerals, vitamins, hormones, medicines, and other important substances throughout the body. Globulins are made by the immune system and in the liver and help fight infection and move nutrients throughout the body.
Abnormally low protein levels can indicate various medical conditions, including liver, digestive, and kidney dysfunction linked to digestion and malabsorption of certain types of proteins and intracellular malnutrition associated with diagnoses such as inflammatory bowel disease, fatty liver disease, and chronic kidney disease. Abnormally high levels can be a sign of inflammation, infection or bone marrow disorder.
Globulin is a protein produced by the immune system and in the liver. Its role is to help fight infection and move nutrients throughout the body. Globulin levels are typically derived by subtracting albumin from total protein. Normal range for adults is 2.0-3.5 g/dL (grams per deciliter of blood). Abnormally high levels may indicate infections, dehydration, immune disorders, autoimmune disease or cancer, whereas abnormally low levels may indicate malnutrition, liver disease, or kidney disease.
This test measures the total amount of calcium in the blood. The body requires calcium to maintain healthy bones and teeth, as well as ensure the nervous system, heart, and muscles function adequately.
If results show low calcium levels, this can indicate under-active parathyroid glands, insufficient calcium in one’s diet, a Vitamin D insufficiency, and other less common conditions. High calcium levels can indicate conditions including overactive parathyroid glands, excessive Vitamin D supplementation, kidney problems as well as more serious causes that may require further investigation. Proper interpretation of calcium levels often requires testing of other parameters such as albumin and total serum protein.
Fasting and certain medications and supplements should be stopped prior to a blood test for accurate results. These medications include:
- Lithium
- Thiazide diuretics
- Antacids containing calcium
- Vitamin D supplements
- Calcium supplements
Additionally, consuming a lot of foods and drinks that contain calcium can increase the levels of calcium in one’s blood and temporarily affect test results.
Magnesium is a critical nutrient that the body needs for more than 300 biochemical reactions, including maintaining normal muscle and nerve function, blood sugar levels, and steady heartbeat and blood pressure. It helps to produce energy, protein, bone, and DNA while also supporting a healthy immune system.
Abnormally low levels of magnesium are often associated with neuromuscular disorders, cardiac arrhythmias, type 2 diabetes, and health conditions in which either the kidneys are excreting too little magnesium or the intestines cannot absorb enough magnesium. Abnormally high levels can indicate kidney dysfunction, also known as renal failure, with not enough magnesium being excreted through urine each day.
Glomerular Filtration Rate (GFR)
GFR Calculator for Adults
This calculator is for people aged 18 years or older.
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According to the National Kidney Foundation, normal results range is: 90 – 120 mL/min/1.73 m2. Older people will have lower than normal GFR levels because GFR decreases with age. There are five stages of chronic kidney disease (CKD) starting with GFR < 90 mL/min for 3 or more months:
- Stage 1 with normal or high GFR (GFR > 90 mL/min)
- Stage 2 Mild CKD (GFR = 60-89 mL/min)
- Stage 3A Moderate CKD (GFR = 45-59 mL/min)
- Stage 3B Moderate CKD (GFR = 30-44 mL/min)
- Stage 4 Severe CKD (GFR = 15-29 mL/min)
- Stage 5 End Stage CKD (GFR <15 mL/min) = kidney failure where dialysis needs to be considered.
Lower than normal GFR/creatinine clearance may indicate:
- Kidney problems, such as damage to the tubule cells, its filtering units or kidney failure
- Too little blood flow to the kidneys
- Loss of body fluids (moderate to severe dehydration)
- Bladder outlet obstruction
- Digestive problems associated with poor metabolism of certain types of protein, underlying food allergy, microbiome imbalance, chronic inflammation, fatty liver disease
- Chronic stress associated with issues with adrenal glands and steroid production (i.e., cortisol)
- Cardiovascular disease
Hemoglobin A1c (HbA1c)
HbA1c Range:
- Normal: < 5.3
- Less than Optimal / Early Diabetes: 5.4 – 6.0
- Diabetes: > 6.0
HbA1C results of 5.4% or higher over an extended period of time indicate corrosion of tissues, blood vessels and organs, which in turn increases the risks of cancer, cardiovascular disease, stroke, diabetes, kidney failure, annual brain shrinkage, blindness, and other diseases.
Lipid panel
There are four types of lipoproteins: low-density lipoproteins (LDL), high-density lipoproteins (HDL), very low-density lipoproteins (VLDL), and chylomicrons. Standard lipid panel blood tests do not measure the size of lipoproteins, VLDL and chylomicrons, and thus do not give a clear indication of the risk of cardiovascular disease and other pathologies. An advanced lipid panel analyzes the makeup of HDL and LDL cholesterol, which allows measuring subtypes – including VLDL and chylomicrons.
The standard blood panel is typically made up of four components:
- Total cholesterol in the blood
- Low-density lipoprotein (LDL) cholesterol – also called “bad cholesterol”
- High-density lipoprotein (HDL) cholesterol – also called “good cholesterol”
- Triglycerides, which make up most of the fat cells in your body.
- Normal optimal range: < 100, and if your triglycerides levels can be lower than your HDL levels that’s optimal
- Concern zones: 100-150
- Warning zone: > 150 – high chance of having cardiovascular and fatty liver disease
LDL cholesterol is much larger than HDL with a diameter of 22 to 29 nm. These lipoproteins have cores that contain large numbers of cholesterol and triglycerides. LDL is considered “bad cholesterol” because it accumulates on the walls of arteries, making them hard and narrow. However, not all LDL cholesterol should be treated equally. Each of the four lipoproteins have a different size. The smaller the LDL particle, the easier it is for it to get through the arteries. Larger LDL particles have a much harder time getting through the narrow canals of the arteries.
Optimal normal levels of LDL are below 70 mg/dl. Abnormally high levels of LDL cholesterol are indicative of poor metabolism by the liver of saturated fats from animal products, dairy-based foods, fish, and nuts along with high rates of cell death and insufficient cellular repair linked to the spleen.
The ratio of total cholesterol to HDL can help determine an individual’s risk of developing heart disease. It is calculated by dividing HDL cholesterol into total cholesterol. Abnormally high levels indicate a higher risk of heart problems.
Common Additional Blood Tests
C-Reactive Protein (CRP) is a protein made by the liver that is sent into the bloodstream in response to inflammation. Inflammation is the body’s way of protecting tissues if one’s been injured or has an infection.
The normal concentration range of CRP in most adults is between 0.8 mg/L and 3.0 mg/L. Abnormally high levels may be an indication of metabolic inflammation, autoimmune issues, serious infection or other disorders.
Apolipoproteins are proteins that bind lipids, such as fat and cholesterol, to form lipoproteins. They transport lipids and fat soluble vitamins in blood, lymph, and the fluid in the spinal cord and brain. Apolipoprotein A (also known as A1) is a primary protein component of HDL (“good”) cholesterol. It helps start the process for HDL to remove bad types of cholesterol from the body.
The normal ranges for adult men are above 120 mg/dL and for adult women are above 140 mg/dL. Abnormally lower levels indicate an increased risk of coronary artery disease. Extremely low ApoA1 (<20 mg/dL) is suggestive of liver disease or a genetic disorder.
Apolipoproteins are proteins that bind lipids, such as fat and cholesterol, to form lipoproteins. They transport lipids and fat soluble vitamins in blood, lymph, and the fluid in the spinal cord and brain. Apolipoprotein B (ApoB) is a primary protein component of LDL (“bad”) cholesterol. Lipoprotein particles that have the potential to cause cardiovascular disease have at least one molecule of apo B on their surface.
The normal range for adults is below 90 mg/dL. Abnormally high levels can indicate higher risk of cardiovascular disease. Extremely low values of ApoB (<48 mg/dL in adults) can indicate malabsorption of food lipids and can lead to polyneuropathy.
An elevated ApoB:ApoA ratio can indicate an increased risk of cardiovascular disease, independently of LDL and HDL cholesterol levels.
Low-density lipoprotein particles (LDL-P) are mechanisms for fat transport that remain in the blood for an extended time. While in circulation, LDL-P can penetrate the artery wall and get stuck, forming plaque. This plaque can accumulate over time and lead to cardiac issues, blockages, heart attacks and strokes.
The LDL-P measures the number of LDL particles that carry LDL cholesterol per liter of plasma. Advanced lipid tests also report the size of these LDL particles, which can help with diagnosing the cause of cholesterol abnormality. For example, increased numbers of small, dense LDL particles can be caused by insulin resistance, a condition that raises the risk for developing diabetes.
Standard lipid panels and testing measure the level of LDL cholesterol (LDL-C) present in the blood, and not the number of LDL particles (LDL-P). LDL-P can be used to get a more precise assessment of LDL due to the variability of cholesterol content within a given LDL. LDL-P has been proven to more accurately predict the risk of cardiovascular disease than LDL-C.
A thyroid panel usually includes tests for: TSH (thyroid-stimulating hormone), Free T4 (thyroxine), and Free T3 or total T3 (triiodothyronine). Thyroid-stimulating hormone is released from the pituitary gland to communicate with the thyroid. The thyroid makes hormones that regulate the way the body uses energy. It also plays a significant role in regulating weight, body temperature, muscle strength, and even one’s mood.
When TSH levels are high, the thyroid typically is not making enough thyroid hormones, a condition called hypothyroidism. When TSH levels are low, the thyroid typically is making too much of the hormones, a condition called hyperthyroidism. If TSH levels are abnormally high or low, it can indicate that the thyroid is not functioning well. The optimal functional range for TSH is 1.8-2.5 mlU/L.
Because 90% of low thyroid function is caused by the autoimmune condition, Hashimoto’s disease, additional thyroglobulin (TGB Ab) and thyroid peroxidase (TPO) antibodies tests are often recommended. High levels of thyroid antibodies show an autoimmune attack against the thyroid.
Thyroglobulin Ab optimal range: 0-0.9 IU/mL
Thyroid Peroxidase (TPO) Ab optimal range: 0-15 IU/mL
The 25-hydroxy vitamin D test is an accurate method to measure how much vitamin D is in the body. Vitamin D is synthesized by the body when one’s bare skin is exposed to sunlight. Vitamin D is among the most important vitamins in its importance and influence on health. Since vitamin D is fat-soluble, it acts more like a hormone than a vitamin by regulating hundreds of pathways in the body. Besides one’s thyroid hormones, vitamin D is the only other thing every single cell of the body needs in order to function properly. Vitamin D also helps control calcium and phosphate levels in the body.
Cholecalciferol, which is 25-hydroxy vitamin D3, is the vitamin D that the body has made or absorbed from animal sources, such as fatty fish or liver, or a cholecalciferol supplement. Ergocalciferol, which is a 25-hydroxy vitamin D2, is the vitamin D that has been absorbed from foods fortified with plant vitamin D or from an ergocalciferol supplement. Since ergo- and cholecalciferol work similarly in the body, the important value is the total 25-hydroxy vitamin D level in the blood.
The optimal range of vitamin D is 60-80 ng/mL. Abnormally low levels can indicate bone diseases, such as osteoporosis or rickets, liver and kidney dysfunction, and poor food absorption. Abnormally high levels can indicate too much calcium in the blood (hypercalcemia), kidney dysfunction, and overactive thyroid or parathyroid glands.
Ferritin is a protein that stores iron inside the cells. The body needs iron to make healthy red blood cells, which carry oxygen from the lungs to the rest of the body. Iron is also important for healthy muscles, bone marrow, and organ function. Ferritin is also considered an acute phase reactant, which serves as a sign of inflammation when the level is higher than normal.
The normal range for blood ferritin is:
- For men, 24 to 336 mg/L (micrograms per liter)
- For women, 11 to 307 mg/L
Abnormally low ferritin levels may indicate an iron deficiency anemia (a disorder in which the body does not produce sufficient red blood cells) or another condition related to low iron levels. Iron deficiency anemia can cause heart problems, infections, and other health issues. Abnormally high ferritin levels may indicate too much iron in your body, liver disease, alcohol abuse, hemochromatosis, heart disease, diabetes, rheumatoid arthritis, other inflammatory conditions or hyperthyroidism.
Vitamin B12, along with folate (Vitamin B9), supports many different cellular functions throughout the body. Vitamin B12 supports nerve function and is essential for making red blood cells.
The normal range is 160 – 950 pg/mL (picograms per milliliter), or 118 – 701 pmol/L (picomoles per liter). Abnormally low levels can indicate gut malabsorption, hyperthyroidism and dietary shortcomings. Abnormally high levels can indicate liver disease or dysfunction.
Folate, which is Vitamin B9, is important in red blood cell formation and for healthy cell growth and function. Folate supports nerve function and is essential for making red blood cells, white blood cells, platelets, and DNA. The nutrient is crucial during early pregnancy to reduce the risk of birth defects of the brain and spine.
A folate test result reflects one’s recent intake of folate and folic acid in the diet. Folate is found in foods such as liver, citrus fruits, dark green, leafy vegetables (such as kale and spinach), whole grains, and beans. Folic acid is the man-made form of folate and found in fortified foods, such as breakfast cereals, and vitamins.
The normal range is 2.7 – 17.0 ng/mL (nanograms per milliliter) or 6.12 – 38.52 nmol/L (nanomoles per liter). Abnormally low folate levels can indicate problems with diet, high alcohol consumption, malabsorption issues, and liver dysfunction.
Ceruloplasmin is a protein made in the liver that binds to and transports copper throughout the body. Our body uses copper to help maintain energy and bone health. It also helps the body make melanin, the substance that gives skin pigment. An abnormally low level may indicate kidney dysfunction, liver dysfunction, malnutrition, malabsorption, copper deficiency or a range of potential disorders (e.g. Menkes syndrome, nephrotic syndrome, Wilson disease). An abnormally high level may indicate chronic infections, cancer, heart disease, overactive thyroid, and rheumatoid arthritis.
Homocysteine is a type of amino acid, a chemical the body uses to make proteins. Normally, vitamin B12, vitamin B6, and folic acid (vitamin B9) break down homocysteine and change it into other substances the body needs. If functioning optimally, this process leaves behind very small levels of homocysteine in the blood. The homocysteine test can help assess the risk of heart disease or stroke and monitor people with heart disease to determine progress.
The normal range should be less than 15.1 µmol/L. Abnormally high levels can indicate a vitamin deficiency (malnourishment or malabsorption), heart disease, hypothyroidism, or other disorders.
Dehydroepiandrosterone sulfate (DHEAS) is a weak male hormone produced mostly by the adrenal glands in both men and women. DHEAS plays an important role in making the male sex hormone testosterone and the female sex hormone estrogen. It is also involved in the development of male sexual characteristics at puberty. DHEAS helps control heart rate, blood pressure, and other body functions. Abnormal DHEAS levels may indicate a problem with the adrenal glands, pituitary glands, or sex organs (testicles or ovaries, such as PCOS (polycystic ovary syndrome)).
DHEAS levels vary by sex and age. The normal range for females are:
- Ages 18-19: 145 – 395 µg/dL (micrograms per deciliter) or 3.92-10.66 µmol/L (micromoles per liter)
- Ages 20-29: 65 – 380 µg/dL or 1.75 – 10.26 µmol/L
- Ages 30-39: 45 – 270 µg/dL or 1.22 – 7.29 µmol/L
- Ages 40-49: 32 – 240 µg/dL or 0.86 – 6.48 µmol/L
- Ages 50-59: 26 – 200 µg/dL or 0.70 – 5.40 µmol/L
- Ages 60-69: 13 – 130 µg/dL or 0.35 – 3.51 µmol/L
- Ages 69 and older: 17 – 90 µg/dL or 0.46 – 2.43 µmol/L
Typical normal ranges for males are:
- Ages 18-19: 108 – 441 µg/dL or 2.92 – 11.91 µmol/L
- Ages 20-29: 280 – 640 µg/dL or 7.56 – 17.28 µmol/L
- Ages 30-39: 120 – 520 µg/dL or 3.24 – 14.04 µmol/L
- Ages 40-49: 95 – 530 µg/dL or 2.56 – 14.31 µmol/L
- Ages 50-59: 70 – 310 µg/dL or 1.89 – 8.37 µmol/L
- Ages 60-69: 42 – 290 µg/dL or 1.13 – 7.83 µmol/L
- Ages 69 and older: 28 – 175 µg/dL or 0.76 – 4.72 µmol/L
Glutathione (GSH) is an antioxidant which helps to boost the immune system as well as prevent and reverse cellular damage. Unlike most antioxidants which come from the food we eat, glutathione is naturally produced by the body in the liver. Glutathione boosts the immune system, helps to break down nutrients in food, and protects us from chronic diseases such as Alzheimer’s, Parkinsons, diabetes, some types of cancer, and heart disease. Glutathione levels tend to decrease naturally with age as well as due to health conditions such as liver disease, insomnia, and chronic stress. By measuring glutathione levels, people can determine if they are deficient and may benefit from supplements or an increased diet of glutathione-rich foods. Foods which can help boost glutathione levels include green leafy vegetables, nuts, garlic, onions, lean protein, and flaxseed.
Insulin-like Growth Factor 1 (IGF-1) is a hormone that, along with growth hormone (GH), helps promote normal bone and tissue growth and development as well as production of lean muscle mass. IGF-1 is primarily produced in the liver, skeletal muscles, and other tissues in response to GH stimulation. IGF-1 mediates many of the actions of GH,and also plays a role in non-growth activities, such as glucose and lipid metabolism, and has been implicated in metabolic syndrome.
Since GH is released into the blood in pulses throughout the day, it is difficult to interpret the results from a single GH test. IGF-1 mirrors GH excesses and deficiencies, but unlike GH, its level is stable throughout the day, which makes IGF-1 a useful indicator of average GH levels. The IGF-1 test is thus often used to help evaluate for GH deficiency or GH excess.
IGF-1 levels, like GH, are normally low in infancy, increase gradually during childhood, peak during puberty, and then decline in adult life. Deficiencies in GH and IGF-1 may be caused by:
- A dysfunctional pituitary gland with decreased pituitary hormones (hypopituitarism)
- A non-GH-producing pituitary tumor that damages cells that produce hormones
- A lack of responsiveness to GH. This insensitivity may be primary (genetic) or secondary to conditions such as malnutrition, hypothyroidism, sex hormone deficiency, kidney disease, liver disease, and congenital syndromes.
Zinc is a trace element found in cells throughout the body that plays a major role in cell division, cell growth, DNA creation, wound and tissue healing, breaking down carbohydrates, and building proteins. Zinc is also involved with the senses of taste and smell. Since zinc supports the functioning of immune cells, even a minor deficiency can reduce lymphocyte, neutrophil, and macrophage activity that protects the body from bacteria and viruses.
Abnormally low levels can be associated with nutritional inadequacy, alcoholic cirrhosis, cystic fibrosis, myocardial infarction, and acute and chronic infections, such as inflammatory bowel disease, chronic liver or kidney disease. Abnormally high levels can be caused by industrial exposure.
Lead is a toxic heavy metal that the body cannot readily metabolize. Lead exposure can occur by eating contaminated foods, such as animal products, drinking contaminated water, and inhaling lead-based fumes (such as from gasoline and paint). After it enters the body, lead can travel to different tissues and organs, including the kidneys and liver, where it can cause damage. Lead negatively alters the DNA and decreases the expression of DNA repair genes.
Since lead is primarily stored in bones, there are much lower amounts present in blood, where tests are taken. Any non-trivial blood lead levels (BLLs) in adults are associated with decreased kidney (renal) function and BLLs > 5 µg/d are associated with increased blood pressure and hypertension. High levels of lead can lead to developmental intellectual disability, heart disease, stroke, as well as respiratory, neurologic, digestive, and urinary diseases.
Arsenic is a toxic heavy metal that the body cannot readily metabolize. Arsenic exposure can occur by drinking contaminated water, eating contaminated foods, such as rice and animal products, and breathing fumes from industrial chemicals, such as weed killers and insecticides. After it enters the body, arsenic quickly integrates into various nonvascular tissues. Arsenic damages the DNA, poisons the beta cells in the pancreas, and causes Type 2 diabetes. Blood tests can only detect blood concentration of arsenic within two days of exposure, whereas urine tests can better assess arsenic exposure. Normal blood arsenic concentrations are <12 ng/mL.
Mercury is a toxic heavy metal that the body cannot readily metabolize. Mercury exposure can occur by eating fish, drinking contaminated water, breathing in coal-based fumes, and working in environments with high levels of mercury. After it enters the body, mercury quickly integrates into various tissues, including collagen tissues and neurons. Mercury damages the kidney, which is regularly trying to clear it. Blood tests can detect blood concentration of mercury within three days of exposure. Normal blood mercury concentrations are <14 ng/mL.
Cadmium is a toxic heavy metal that the body cannot readily metabolize. Cadmium exposure can occur by smoking cigarettes, eating animal products, eating industrially-farmed soybeans, rice, and leafy greens, breathing in spray paints, and working in an auto mechanic repair shop. Cadmium exposure can damage the kidney (renal dysfunction) and cause pneumonia, emphysema, and fatigue. Blood tests reflect recent cadmium exposure whereas urine tests assess lifetime cadmium exposure. Normal blood cadmium concentrations are <1.2 ng/mL.
Iodine is a trace element found in specific foods that help make thyroid hormones. Thyroid hormones control the body’s metabolism, protein synthesis, enzyme activity and other important functions. During pregnancy and infancy, the body also needs thyroid hormones for proper bone, brain, and central nervous system development.
In normal circumstances, the body controls thyroid function and hormone concentrations via thyroid-stimulating hormone (TSH), also known as thyrotropin. TSH secretion typically increases when iodine intake falls below 100 mcg/day. TSH increases the thyroid’s iodine uptake from the blood and the production of thyroid hormone. However, very low iodine intakes can reduce thyroid hormone production even in the presence of elevated TSH levels.