Common Diagnostic Procedure of Blood Tests

Common Diagnostic Procedure of 

Blood Tests

a). Body area tested: Usually blood sample from an arm.

b). Measurement of substances in the blood to evaluate organ function and to help diagnose        and monitor various disorders.

Common Blood Tests;

Tests                                              Reference Range

Acidity(pH)                                  7.35-7.45

Acidity and alkalinity are expressed on the pH scale, which ranges from 0 (stronglyacidic) to 14 (strongly basic or alkaline). A pH of 7.0, in the middle of this scale, is neutral. Blood is normally slightly basic, with a normal pH range of 7.35 to 7.45. Usually the body maintains the pH of blood close to 7.40.

Alcohol (Ethanol)                       More than 0.1 mg/dL usually indicates intoxication.

The ethanol test, commonly known as alcohol test, is used for both medical and legal purposes. Samples and results for each use are usually collected and tested separately.

Medical: medical testing is used to determine the level of ethanol in the blood in order to effectively treat the intoxicated person's symptoms. Blood is the most common sample used for medical alcohol tests. The tests may be ordered for a person who presents to the emergency room with signs and symptoms suggesting ethanol toxicity.

Ammonia                                      15 - 50 ug of nitrogen / dL

Most ammonia in the body forms when protein is broken down by bacteria in the intestines . The liver normally converts ammonia into urea, which is then eliminated in urine. Ammonia levels in the blood rise when the liver is not able to convert ammonia to urea. This may be caused by cirrhosis or severe hepatitis.

Amylase                                         53 - 123 units / L

An amylase test measures the amount of this enzyme in a sample of blood taken from a vein or in a sample of urine. Normally, only low levels of amylase are found in the blood or urine. But if the pancreas or salivary glands become damaged or blocked, more amylase is usually released into the blood and urine.

Ascorbic acid                                0.4 - 1.5 mg /  dL

Scurvy is caused by prolonged dietary deficiency of vitamin C(ascorbic acid). Vitamin C levels generally reflect recent intake amounts more than body stores. Vitamin C levels of less than 0.3 mg/dL indicate significant deficiency, while levels that exceed 0.6 mg/dL indicate sufficient intake.

Bicarbonate                                  18 - 23 mEq / L

Carbon dioxide (CO2) is a gaseous waste product from metabolism. The bloodcarries carbon dioxide to your lungs, where it is exhaled. More than 90% of it in your blood exists in the form of bicarbonate (HCO3). The rest of it is either dissolved carbon dioxide gas (CO2) or carbonic acid (H2CO3). Your kidneys and lungs balance the levels of carbon dioxide, bicarbonate, and carbonic acid in the blood.

This test measures the level of bicarbonate in a sample of blood from a vein. Bicarbonate is a chemical that acts as a buffer. It keeps the pH of blood from becoming too acidic or too basic.

Bicarbonate is not usually tested by itself. The test may be done on a blood sample taken from a vein as part of a panel of tests that looks at other electrolytes. These may include items such as sodium, potassium, and chloride. It can also be done as part of an arterial blood gas (ABG) test. For this blood gas study, the blood sample comes from an artery.

Why It Is Done

A carbon dioxide test helps find and checks conditions that affect blood bicarbonate levels. These include many kidneydiseases, some lung diseases, and metabolic problems.

This test is often done as part of a group of lab blood tests (chemistry screen) to help find the cause of many kinds of symptoms.

Bilirubin                                        Direct: up to 0.4 mg/dL

                                                         Total  : up to 1.0 mg/dL

A bilirubin test is used to help determine the cause of jaundice, a yellowing of your skin and the whites of your eyes. It helps diagnose conditions like liver disease, hemolytic anemia, and blocked bile ducts.

Blood Volume                               8.5 - 9.1 % of body weight

What is a blood volume test?

A blood volume test (also called a plasma volume test or a red cell mass test) is a nuclear lab procedure used to measure the volume (amount) of blood in the body. The test also measures the volume of plasma and of red cells in the blood.

What is syncope?

Syncope (pronounced "sin ko pea") is the brief loss of consciousness and posture caused by a temporary decrease in blood flow to the brain. Syncope may be associated with a sudden fall in blood pressure, a decrease in heart rate or changes in blood volume or distribution. The person usually regains consciousness and becomes alert right away, but may experience a brief period of confusion.

Syncope is often the result of an underlying medical condition that could be related to your heart, nervous system or blood flow to the brain.

A blood volume test can be used in the diagnosis of these conditions:

• Hypovolemia (low blood volume)
• Hypervolemia (high blood volume)
• Anemia (low red cell volume)
• Polycythemia (high red cell volume)

A blood volume test also helps in the evaluation and treatment of these conditions:

• Orthostatic hypotension (low blood pressure while upright)
• Hypertension (high blood pressure)
• Heart failure (decreased pumping power of the heart)
• Shock
• Medical conditions associated with acute blood loss

A blood volume test may be used in the evaluation of these treatments:

• Kidney dialysis
• Pre-operative hemodilution (blood dilution) therapy
• Pre- and post-evaluation of fluid status
• Pseudo-anemia detection secondary to fluid retention
• Blood transfusion therapy/precise volume replacement

Calcium                                          8.5 - 10.5 mg/dL (sightly higher in children)

A blood calcium test is ordered to screen for, diagnose, and monitor a range of conditions relating to the bones, heart, nerves, kidneys, and teeth. The test may also be ordered if a person has symptoms of a parathyroid disorder, malabsorption, or an overactive thyroid.

Carbon monoxide                         Less than 5% of total hemoglobin

A carbon monoxide blood test is used to detect poisoning from breathing carbon monoxide (CO), a colorless, odorless, poisonous gas. The test measures the amount of hemoglobin that has bonded with carbon monoxide. This amount is also called the carboxyhemoglobin level. See a picture of what happens during carbon monoxide poisoning.

When a person inhales carbon monoxide, it combines with the red blood cells that normally carry oxygen to the body's tissues and replaces the oxygen that is normally carried in the blood. As a result, less oxygen is carried to the brain and other body tissues. Carbon monoxide can cause severe poisoning and death.

Carbon monoxide is made during burning when there is not enough oxygen present for complete combustion. The main sources of carbon monoxide are engine fumes (such as from cars or boats), fires burning with poor ventilation (such as gas heaters and indoor cooking fires), factories, and smoking  tobacco.

CD4 cell count                               500 - 1500 cells / uL

These are the cells that the HIV virus kills. As HIV infection progresses, the number of these cells declines. When the CD4 count drops below 200 due to advanced HIV disease, a person is diagnosed with AIDS. A normal range for CD4 cells is about 500-1,500

Ceruloplasmin                               15 - 60 mg/dL

Ceruloplasmin testing is used primarily, along with blood and/or urine copper tests, to help diagnose Wilson disease, a rare inherited disorder associated with excess storage of copper in the liver, brain, and other organs, and with decreased levels ofceruloplasmin.

Chloride                                          98- 106 mEq/L

It helps keep the amount of fluid inside and outside of your cells in balance. It also helps maintain proper blood volume, blood pressure, and pH of your body fluids. Tests for sodium, potassium, and bicarbonate are usually done at the same time as a blood test for chloride.

What causes low chloride in blood?

Many people do not notice any symptoms, unless they are experiencing very high or very low levels of chloride in their blood. Dehydration, fluid loss, or high levels ofblood sodium may be noted. You may be experiencing other forms of fluid loss, such as diarrhea, or vomiting.

What does it mean when your chloride is high in a blood test?

An increased level of blood chloride (called hyperchloremia) usually indicates dehydration, but can also occur with other problems that cause high blood sodium, such as Cushing syndrome or kidney disease.

Copper                                             Total: 70 - 150 ug/dL

This test measures the total amount of copper in your blood. Normally most of the copper in your blood is carried by a protein called ceruloplasmin.

Adults have 50 and 80 milligrams (mg) of copper in their body, mostly in muscle and the liver. Copper helps make melanin, bone, and connective tissue. It also helps with many other processes in your body. You normally get copper through your diet, in foods like liver and other organ meats, seafood, beans, and whole grains. You get rid of copper in your bowel movements and urine.

Various health problems can disrupt normal copper levels. This can cause you to have too little copper (copper deficiency) or too much copper (copper toxicity). 

Because a normal diet has plenty of copper, copper deficiency is unlikely except in certain cases. It can occur in malnourished children. This is especially true for premature babies who don't get nutritional supplements. Children with this condition tend to have bone abnormalities and fractures. Copper deficiency can also result from a rare genetic disorder called Menkes disease. This syndrome interferes with copper absorption. Copper deficiency can lead to problems with connective tissue, muscle weakness, anemia, low white blood cell count, neurological problems, and paleness.

Too much copper can be toxic. You can get too much copper from dietary supplements or from drinking contaminated water. You can also get too much copper from being around fungicides that have copper sulfate. You can also have too much copper if you have a condition that stops the body from getting rid of copper. For example, Wilson disease keeps the liver from storing copper safely and from sending copper out of the body in your stool. Extra copper in the liver overflows and builds up in the kidneys, brain, and eyes. This extra copper can kill liver cells and cause nerve damage. Wilson disease is fatal if untreated. Extra copper can also interfere with how your body absorbs zinc and iron. 

You may need this test if you have symptoms of either copper deficiency or copper toxicity.

Signs and symptoms of copper deficiency can include:

• Anemia
• A low level of white blood cells called neutrophils (neutropenia)
• Osteoporosis
• Paleness
• Hair with less pigment than normal

Children with copper deficiency through malnutrition or another condition may have vascular aneurysms, central nervous system problems, stunted growth, poor muscle tone and muscle weakness, and hypothermia.

Symptoms of copper toxicity include:

• Belly pain
• Diarrhea
• Vomiting

In more severe forms, copper toxicity can lead to:

• Heart and kidney failure
• Liver damage
• Brain disease or disorder
• Death

Signs and symptoms of Wilson disease include:

• Anemia
• Low white blood cell count
• Kayser-Fleischer rings. These are brown rings around the cornea that are visible to a healthcare provider during an eye exam.

If you have Wilson disease, your provider may order this test to make sure your treatment is working. 

Creatine kinase (CK)                    Male: 38 - 174 units/L

                                                          Female: 96 - 140 units/L

creatine kinase

CK stands for creatine kinase, an enzyme that leaks out of damaged muscle. When elevated CK levels are found in a blood sample, it usually means muscle is being destroyed by some abnormal process, such as a muscular dystrophy or inflammation.

What is a creatine kinase blood test?

This test measures the amount of an enzyme called creatine kinase (CK) in your blood. ... The muscle cells in your body need CK to function. Levels of CK can rise after a heart attack, skeletal muscle injury, strenuous exercise, or drinking too much alcohol, and from taking certain medicines or supplements.

Increased CK may be seen with, for example:

• Recent crush and compression muscle injuries, trauma, burns, and electrocution.
• Inherited myopathies, such as muscular dystrophy.
• Hormonal (endocrine) disorders, such as thyroid disorders, Addison disease or Cushing disease.
• Strenuous exercise.
• Prolonged surgeries.
• Seizures.

Creatine                                          0.6 - 1.2 mg/dL

A creatinine blood test measures the level of creatinine in the blood. Creatinine is a waste product that forms when creatine, which is found in your muscle, breaks down. Creatinine levels in the blood can provide your doctor with information about how well your kidneysare working.

Erythrocyte sedimentation         Male: 1 -13 mm/hr

 rate (ESR)                                      Female: 1 - 20 mm/hr

Sed rate, or erythrocyte sedimentation rate (ESR), is a blood test that can reveal inflammatory activity in your body. A sed rate test isn't a stand-alone diagnostic tool, but it can help your doctor diagnose or monitor the progress of an inflammatory disease.

When your blood is placed in a tall, thin tube, red blood cells (erythrocytes) gradually settle to the bottom. Inflammation can cause the cells to clump. Because these clumps are denser than individual cells, they settle to the bottom more quickly.

The sed rate test measures the distance red blood cells fall in a test tube in one hour. The farther the red blood cells have descended, the greater the inflammatory response of your immune system.

Why it's done

Sed rate tests might be useful when evaluating unexplained fever, some types of arthritis and symptoms that affect your muscles. Also, they can help confirm a diagnosis of certain conditions, including:

• Giant cell arteritis
• Polymyalgia rheumatica
• Rheumatoid arthritis

A sed rate test can also help determine the severity of your inflammatory response and monitor the effect of treatment.

Because a sed rate test can't pinpoint the problem that's causing inflammation in your body, it's usually accompanied by other blood tests, such as the C-reactive protein (CRP) test.

Glucose                                            Fasting: 70  - 110 mg/dL

Symptoms of type 1 diabetes often appear suddenly and are often the reason for checking blood sugar levels. Because symptoms of other types of diabetes and prediabetes come on more gradually or may not be evident, the American Diabetes Association (ADA) has recommended screening guidelines. The ADA recommends that the following people be screened for diabetes:

• Anyone with a body mass index higher than 25, regardless of age, who has additional risk factors, such as high blood pressure, a sedentary lifestyle, a history of polycystic ovary syndrome, having delivered a baby who weighed more than 9 pounds, a history of diabetes in pregnancy, high cholesterol levels, a history of heart disease, and having a close relative with diabetes.
• Anyone older than age 45 is advised to receive an initial blood sugar screening, and then, if the results are normal, to be screened every three years thereafter.

Tests for type 1 and type 2 diabetes and prediabetes

• Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal.

If the A1C test results aren't consistent, the test isn't available, or if you have certain conditions that can make the A1C test inaccurate — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — your doctor may use the following tests to diagnose diabetes:

• Random blood sugar test. A blood sample will be taken at a random time. Regardless of when you last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or higher suggests diabetes.
• Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.
• Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes. A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.

If type 1 diabetes is suspected, your urine will be tested to look for the presence of a byproduct produced when muscle and fat tissue are used for energy when the body doesn't have enough insulin to use the available glucose (ketones). Your doctor will also likely run a test to see if you have the destructive immune system cells associated with type 1 diabetes called autoantibodies.

Tests for gestational diabetes

Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy:

• If you're at high risk of gestational diabetes — for example, if you were obese at the start of your pregnancy, you had gestational diabetes during a previous pregnancy, or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit.
• If you're at average risk of gestational diabetes, you'll likely have a screening test for gestational diabetes sometime during your second trimester — typically between 24 and 28 weeks of pregnancy.

Your doctor may use the following screening tests:

• Initial glucose challenge test. You'll begin the glucose challenge test by drinking a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 140 mg/dL (7.2 to 7.8 mmol/L) is usually considered normal on a glucose challenge test, although this may vary at specific clinics or labs. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. Your doctor will order a follow-up test to determine if you have gestational diabetes.
• Follow-up glucose tolerance testing. For the follow-up test, you'll be asked to fast overnight and then have your fasting blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for a period of three hours. If at least two of the blood sugar readings are higher than the normal values established for each of the three hours of the test, you'll be diagnosed with gestational diabetes.

Hemartocrit                                    Male: 45 - 52% 
                                                           Female: 37-48%

he hematocrit test is often used to check for anemia, usually along with a hemoglobin test or as part of a complete blood count (CBC). The test may be used to screen for, diagnose, or monitor a number of conditions and diseases that affect the proportion of the blood made up of red blood cells (RBCs).

Hemoglobin                                    Male: 13 - 18 gm/dL
                                                           Female: 12 - 16 gm/dL

Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs. If a hemoglobin testreveals that your hemoglobin level is lower than normal, it means you have a low red blood cell count (anemia).

Iron                                                   60 - 160 ug/dL (Higher in males)

Iron is a mineral in your body that comes from foods like red meat and fortified cereals or from supplements you take. You need iron to make red blood cells. Iron is also an important part of hemoglobin, a protein in your blood that helps carry oxygen from your lungs to the rest of your body.

An iron test can show if you have too much or too little of this mineral in your system. It can check for conditions like anemia, or iron overload (excess iron). Your doctor might order a test if you have symptoms of either condition.

Symptoms of low iron include:

• Tiredness
• Dizziness
• Weakness
• Headaches
• Pale skin
• Fast heartbeat

Symptoms of high iron include:

• Joint pain
• Tiredness
• Weakness or a lack of energy
• Stomach pain

Types of Iron Blood Tests

There are several different tests to check the level of iron in your body. These tests show how much of the mineral is moving through your blood, how well your blood carries it, and how much iron is stored in your tissues.

• Serum iron. This test measures the amount of iron in your blood.
• Serum ferritin. This test measures how much iron is stored in your body. When your iron level is low, your body will pull iron out of “storage” to use.
• Total iron-binding capacity (TIBC).This test tells how much transferrin (a protein) is free to carry iron through your blood. If your TIBC level is high, it means more transferrin is free because you have low iron.
• Unsaturated iron-binding capacity (UIBC). This test measures how much transferrin isn’t attached to iron.
• Transferrin saturation. This test measures the percentage of transferrin that is attached to iron.

Taking the Tests

Some tests require you to stop eating about 12 hours before you give blood. Your health care provider will take a sample from a vein in your arm and send it to a lab. The lab results will show whether iron levels in your blood are too high or too low.

A low iron level can be caused by:

• A lack of iron in your diet
• Trouble absorbing iron from foods you eat
• Blood loss
• Pregnancy

Iorn - Binding Capacity                250 -460 ug/dL

Total iron binding capacity (TIBC) is a blood test to see if you have too much or too little iron in your blood. Iron moves through the blood attached to a protein called transferrin. This test helps your health care provider know how well that protein can carry iron in your blood.

Lactate (Lactic acid)                      Venous 4.5 - 19.8 mg/dL
                                                           Arterial 4.5-14.4 mg/dL

It’s a test that measures the amount of lactic acid (also called “lactate”) in your blood.

This acid is made in muscle cells and red blood cells. It forms when your body turns food into energy. Your body relies on this energy when its oxygen levels are low. Oxygen levels might drop during an intense workout or when you have an infection or disease. Once you finish your workout or recover from the illness, your lactic acid level tends to go back to normal.

But sometimes, it doesn't.

Symptoms of Lactic Acidosis

Higher-than-normal lactic acid levels can lead to a condition called lactic acidosis. If it’s severe enough, it can upset your body’s pH balance, which indicates the level of acid in your blood. Lactic acidosis can lead to these symptoms:

• muscle weakness
• rapid breathing
• vomiting
• sweating
• coma

How Is the Test Done?

It’s a simple blood test. Your doctor will draw blood from a vein or artery using a needle. In rare cases, he may take a sample of cerebrospinal fluid from your spinal column during a procedure called a spinal tap.

Normally, you don’t have to adjust your routine to prepare for the test.

The Results

If your lactic acid level is normal, you don’t have lactic acidosis. Your cells are making enough oxygen. It also tells your doctor that something other than lactic acidosis is causing your symptoms. He’ll likely order other tests to find out what it is.

If your lactic acid level is high, it could be caused by a number of things. Most often, it’s because you have a condition that makes it hard for you to breathe in enough oxygen. Some of these conditions could include:

• Sepsis
• Heart attack
• Congestive heart failure
• Severe lung disease or respiratory failure
• Fluid build-up in your lungs
• Very low red blood cell count (severe anemia)

A higher-than-normal lactic acid level in your blood can also be a sign of problems with your metabolism. And, your body might need more oxygen than normal because you have one of the following conditions:

• Liver disease
• Kidney disease
• Diabetes that’s not under control
• Leukemia
• AIDS

Elevated lactic acid levels can also mean you’re not getting enough vitamin B1.

Lactic dehydrogenase                    50 - 150 units/L

The lactate dehydrogenase (LDH) test looks for signs of damage to the body’s tissues.

LDH is an enzyme found in almost every cell of your body, including your blood, muscles, brain, kidneys, and pancreas.

The enzyme turns sugar into energy. The LDH test measures the amount of LDH in your blood or other body fluid.

When cells are damaged or destroyed, this enzyme is released into the fluid portion of blood. Doctors call this “serum” or “plasma.” LDH can also be released into other body fluid, including cerebrospinal fluid, which surrounds your brain and spinal cord.

Why Would I Need an LDH Test?

Your doctor might order one for any number of reasons, such as:

• To measure whether you have tissue damage and, if so, how much
• To monitor severe infections or conditions like hemolytic or megaloblastic anemias, kidney disease, and liver disease
• To help evaluate certain cancers or your cancer treatment

Depending on your condition, you may have LDH tests on a regular basis.

You might have an LDH test of body fluids to:

• Find the cause of fluid buildup. It could be due to many things, like injury and inflammation. (It could also be brought on by an imbalance in the pressure within blood vessels and the amount of protein in your blood.)
• Help determine if you have bacterial or viral meningitis.

Lead                                                  40 ug/dL or less

Your child's doctor may recommend your child be tested for lead levels during routine check-ups.

The American Academy of Pediatricians recommends that doctors and parents follow the recommendations of their state or local health department. Some areas, such as those with older homes, have a higher lead exposure risk, so more frequent testing might be recommended for children who live in those areas.

If your area doesn't have specific lead testing recommendations, the American Academy of Pediatrics recommends your child be tested for lead levels at ages 1 and 2. Doctors might also suggest lead screening for older children who haven't been tested.

A simple blood test can detect lead poisoning. A small blood sample is taken from a finger prick or from a vein. Lead levels in the blood are measured in micrograms per deciliter (mcg/dL).

There is no safe blood level of lead. However, a level of 5 mcg/dL is used to indicate a possibly unsafe level for children. Children whose blood tests at those levels should be tested periodically. A child whose levels become too high — generally 45 mcg/dL or higher — should be treated.

Treatment

The first step in treating lead poisoning is to remove the source of the contamination. If you can't remove lead from your environment, you might be able to reduce the likelihood that it will cause problems.

For instance, sometimes it's better to seal in rather than remove old lead paint. Your local health department can recommend ways to identify and reduce lead in your home and community.

For children and adults with relatively low lead levels, simply avoiding exposure to lead might be enough to reduce blood lead levels.

Treating higher levels

For more-severe cases, your doctor might recommend:

• Chelation therapy. In this treatment, a medication given by mouth binds with the lead so that it's excreted in urine. Chelation therapy might be recommended for children with a blood level of 45 mcg/dL or greater and adults with high blood levels of lead or symptoms of lead poisoning.
• EDTA chelation therapy. Doctors treat adults with lead levels greater than 45 mcg/dL of blood and children who can't tolerate the drug used in conventional chelation therapy most commonly with a chemical called calcium disodium ethylenediaminetetraacetic acid (EDTA). EDTA is given by injection.

Lipase                                               10 -150 units/L

A lipase test measures the amount of this enzyme in a blood sample. Highamounts of lipase may be found in the blood when the pancreas is damaged or when the tube leading from the pancreas (pancreatic duct) to the beginning of the small intestine is blocked.

Magnesium                                      1.5 - 2.0 mEq/L

Magnesium testing may be ordered as a follow up to chronically low blood levels ofcalcium and potassium. It also may be ordered when a person has symptoms that may be due to a magnesium deficiency, such as muscle weakness, twitching,cramping, confusion, cardiac arrhythmias, and seizures.

Mean Corpuscular Hemoglobin
(MCH)                                              27 - 32 pg/cell

Red blood cell (RBC) indices are part of the complete blood count (CBC) test. They are used to help diagnose the cause of anemia, a condition in which there are too few red blood cells. The indices include: Average red blood cell size (MCV)Hemoglobin amount per red blood cell (MCH)

Mean corpuscular
Hemoglobin Concentration         
(MCHC)                   

 The Mean corpuscular hemoglobin concentration, a measure of the concentration of haemoglobin in a given volume of packed red blood cells. It is reported as part of a standard complete blood count.
It is calculated by dividing the haemoglobin by the haematocrit. Reference ranges for blood tests are 32 to 36 g/dL, or between 19.9 and 22.3 mmol/L. It is thus a mass or molar concentration. Still, many instances measure MCHC in percentage(%), as if it were a mass fraction (m_Hb / m_RBC). Numerically, however, the MCHC in g/dL and the mass fraction of haemoglobin in red blood cells in % are identical, assuming a RBC density of 1g/mL and negligible haemoglobin in plasma.        

Mean Corpuscular Volume(MCV) 76 - 100 cu um

Mean corpuscular volume (MCV) is the average volume of red cells in a specimen. MCV is elevated or decreased in accordance with average red cell size; ie, low MCV indicates microcytic (small average RBC size), normal MCV indicates normocytic (normal average RBC size), and high MCV indicates macrocytic (large average RBC size).

The reference range for MCV is 80-96 fL/red cell in adult. Reference ranges may vary depending on the individual laboratory and patient's age.
Mean corpuscular volume (MCV) is the average volume of red cells. It can be directly measured by automated hematology analyzer, or it can be calculated from hematocrit (Hct) and the red blood cell count (RBC) as follows: MCV in fl = (Hct [in L/L]/RBC [in x10 ¹²/L]) x 1000.

Osmolality                                       280 - 296 mOsm/kg water

A serum osmolality test measures the amount of chemicals dissolved in the liquid part (serum) of the blood. Chemicals that affect serum osmolality include sodium, chloride, bicarbonate, proteins, and sugar (glucose). This test is done on a bloodsample taken from a vein.
Osmolality is a measure of how much one substance has dissolved in another substance. ... The blood osmolality test is also known as a serum osmolality test. Serum is the liquid part of your blood. The serum test is used mainly to evaluate hyponatremia, a below normal level of sodium in the bloodstream.

What is the osmolarity of blood?

Osmolality of blood increases with dehydration and decreases with overhydration. In normal people, increased osmolality in the blood will stimulate secretion of antidiuretic hormone (ADH). This will result in increased water reabsorption, more concentrated urine, and less concentrated blood plasma.

What does it mean to have low osmolality?

This hormone causes the kidneys to reabsorb water. This results in more concentrated urine. The reabsorbed water dilutes the blood. This allows bloodosmolality to fall back to normal. Low blood osmolality suppresses ADH.

Oxygen saturation (aterial)        96 - 100%

An arterial blood gas (ABG) test measures the acidity (pH) and the levels ofoxygen and carbon dioxide in the blood from an artery. This test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. ... An ABG measures: Partial pressure of oxygen (PaO2).

Phosphatase(acid), prostatic      0 - 3 units/d (Bodansky units)

Clinical Information 

Prostatic acid phosphatase (PAP), a glycoprotein synthesized by the prostate gland, is a member of a diverse group of isoenzymes, the acid phosphatases, which are capable of hydrolyzing phosphate esters in acidic medium. They are classified on the basis of their electrophoretic mobilities.

PAP was a major tumor marker for prostate cancer for more than 50 years.(1) However, PAP is no longer used to screen for or stage prostate cancer. In most instances, serum prostate specific antigen (PSA) is used instead. PAP usefulness is now limited to niche applications. Pre-treatment PAP measurement may add unique, clinically useful prognostic information for predicting recurrence in men who are undergoing radical prostatectomy for clinically localized prostate cancer. PAP also may be useful for following the progression of disease response to therapy in men treated by androgen ablation. However, for both of these applications, PSA provides more information and also should be utilized.

Reference Values 

< or =2.1 ng/mL

Interpretation 

Prostatic acid phosphatase (PAP) levels above the reference range may indicate prostate cancer, but can be due to many other factors, see Cautions.

A rise in PAP levels in patients with known prostate cancer can indicate tumor progression or recurrence. However, there is considerable intra-subject biological variability, limiting the usefulness of this test.

Cautions 

Prostatic acid phosphatase (PAP) measurement must not be regarded as an absolute test for malignancy since other factors, including benign prostatic hyperplasia, prostatic infarction, and manipulation of the prostate gland may result in elevated serum PAP concentrations.

PAP measurements provide little additional information beyond that provided by prostate-specific antigen measurements.

Human anti-mouse antibodies (HAMA) may be present in specimens from patients who have received immunotherapy utilizing monoclonal antibodies. Other heterophile antibodies also may be present in patient specimens. This assay has been specifically formulated to minimize the effects of these antibodies on the assay. However, carefully evaluate results from patients known to have such antibodies.

Phosphatase (alkaline)                50 - 160 units/L

An alkaline phosphatase level test (ALP test) measures the amount of alkaline phosphatase enzyme in your bloodstream. The test requires a simple blood draw and is often a routine part of other blood tests. Abnormal levels of ALP in your blood most often indicate a problem with your liver, gallbladder, or bones.

Phosphorus (Inorganic)              3.0 - 4.5  mg/dL

Why do you test for phosphorus?

Phosphorus is a mineral the body needs to build strong bones and teeth. It is also important for nerve signaling and muscle contraction. This test is ordered to see how much phosphorus is in your blood. Kidney, liver, and certain bone diseases can cause abnormal phosphorus levels.

What is phosphorus inorganic?

Phosphorus occurs in blood in the form of inorganic phosphate and organically bound phosphoric acid. The small amount of extracellular organic phosphorus is found exclusively in the form of phospholipids. ... Hyperphosphatemia is usually secondary to an inability of the kidneys to excrete phosphate.

What is the blood test for phosphorus?

The body needs phosphorus to build and repair bones and teeth, help nerves function, and make muscles contract. Most (about 85%) of the phosphoruscontained in phosphate is found in bones. The rest of it is stored in tissues throughout the body. The kidneys help control the amount of phosphate in theblood.

Platelet Count                                150,000 - 350,000/mL

The normal number of platelets in the blood is 150,000 to 400,000 platelets per microliter (mcL) or 150 to 400 × 10⁹/L. Normal value ranges may vary slightly. Some lab use different measurements or may test different specimens. Talk to your doctor about your test results.

Why would platelets be high?

Primary thrombocytosis, also known as essential thrombocythemia (or ET), is a disease in which abnormal cells in the bone marrow cause an increase in platelets. The cause is unknown. ... Secondary thrombocytosis is caused by another condition the patient may be suffering from, such as: Anemia due to iron deficiency.

What does low platelets mean in a blood test?

If for any reason your blood platelet count falls below normal, the condition is calledthrombocytopenia. Normally, you have anywhere from 150,000 to 450,000platelets per microliter of circulating blood. ... Thrombocytopenia can be inherited or it may be caused by a number of medications or conditions.

What does it mean when your platelet count is low?

When your skin is injured or broken, platelets clump together and form clots to stop the bleeding. When you don't have enough platelets in your blood, your body cannot form clots. A low platelet count may also be called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause.

Potassium                                       3.5 - 5.0 mEq/L

A potassium blood test is often included in a series of routine blood tests called an electrolyte panel. The test may also be used to monitor or diagnose conditions related to abnormal potassium levels. These conditions include kidney disease, high blood pressure, and heart disease.

Why would Potassium be high?

This falsely raises the amount of potassium in the blood sample, even though thepotassium level in your body is actually normal. When this is suspected, a repeat blood sample is done. The most common cause of genuinely high potassium(hyperkalemia) is related to your kidneys, such as: Acute kidney failure.

Why do I need an electrolyte blood test?

An electrolyte test can help determine whether there's an electrolyte imbalance in the body. Electrolytes are salts and minerals, such as sodium, potassium, chloride and bicarbonate, which are found in the blood. They can conduct electrical impulses in the body.

What is included in an electrolyte panel?

An electrolyte panel is a blood test that measures the levels of electrolytes and carbon dioxide in your blood. Electrolytes are minerals, such as sodium and potassium, that are found in the body.

Prostate - specific antigen           0 - 4 ng/mL (increases with age)
(PSA)

Prostate Specific Antigen PSA, is an enzyme found in the blood produced exclusively by prostate cells. Normal levels of PSA in the blood are small amounts between 0-2.5 ng/ml. Higher than normal levels, greater than 2.5 ng/ml, can be caused by cancer or benign, non-cancerous conditions such as enlarged prostate, prostate inflammation, infection, or trauma. All elevated readings of PSA should be checked.

Occasionally, a Digital Rectal Exam, DRE, does not reveal any abnormalities, but the PSA is elevated. Sometimes the opposite is true, and PSA is normal, but the DRE is abnormal. For this reason, the Prostate Specific Antigen PSA blood test together with the DRE is best for early detection.

Normal prostate cells and prostate cancer cells make PSA even if they are outside the prostate. That is why PSA monitoring after treatment is so important. Returning prostate cancer cells, confined to the prostate or that have spread to the bone or lymph nodes, will cause the PSA to rise. Prostate Specific Antigen PSA is important for diagnosis, treatment and follow-up as well as useful for comparing treatment results.

Protein                                             Total: 6.0 - 8.4 gm/dL

The biuret test (Piotrowski's test) is a chemical test used for detecting the presence of peptide bonds. In the presence of peptides, a copper(II) ion forms violet-colored coordination complexes in an alkaline solution. Several variants on the test have been developed, such as the BCA test and the Modified Lowery test.

The biuret reaction can be used to assess the concentration of proteins because peptide bonds occur with the same frequency per amino acid in the peptide. The intensity of the color, and hence the absorption at 540 nm, is directly proportional to the protein concentration, according to the Beer-Lambert law.

Despite its name, the reagent does not in fact contain biuret ((H₂N-CO-)₂NH). The test is named so because it also gives a positive reaction to the peptide-like bonds in the biuret molecule.

In this assay, the copper(II) binds with nitrogens present in the peptides of proteins. In a secondary reaction, the copper(II) is reduced to copper(I). Buffers, such as Tris and ammonia interfere with this assay, therefore rendering this assay inappropriate for protein samples purified from ammonium sulfate precipitation. Due to its insensitivity and little interference by free amino acids, this assay is most useful for whole tissue samples and other sources with high protein concentration.

Ablumin                                           3.5 - 5.0 gm/dL

This test measures the amount of the protein albumin in your blood. Your liver makes albumin. Albumin carries substances such as hormones, medicines, and enzymes throughout your body. This test can help diagnose, evaluate, and watch kidney and liver conditions.

Globulin                                           2.3 - 3.5 gm/dL

High globulin levels may be caused by: Diseases of the blood, such as multiple myeloma, Hodgkin's lymphoma, leukemia, macroglobulinemia, or hemolytic anemia. An autoimmune disease, such as rheumatoid arthritis, lupus, autoimmune hepatitis, or sarcoidosis. Kidney disease.

Pyruvic acid                                     0.3 - 0.9 mg/dL

The lactate:pyruvate (L:P) ratio is considered a helpful (not diagnostic) tool in the evaluation of patients with possible disorders of mitochondrial metabolism, especially in patients with neurologic dysfunction and normal blood L:P ratios. Pyruvic acid levels alone have little clinical utility.

Red blood cell (RBC) count          4.2 -5.9 million/uL/cu mm

A red blood cell count is a blood test that your doctor uses to find out how many red blood cells (RBCs) you have. It's also known as an erythrocyte count. The test is important because RBCs contain hemoglobin, which carries oxygen to your body's tissues. ... Your tissues need oxygen to function.

Sodium                                             135 - 145 mEq/L

A sodium blood test is used to detect abnormal concentrations of sodium, including low sodium (hyponatremia) and high sodium (hypernatremia). It is often used as part of an electrolyte panel or basic metabolic panel for a routine health checkup. ... Blood sodium can be abnormal in many diseases.

Thyroid - stimulating homone     0.5 - 5.0 u units/mL
(TSH)

This test measures the amount of TSH in the blood. Thyroid-stimulating hormone(TSH) is produced by the pituitary gland, a tiny organ located below the brain and behind the sinus cavities. TSH stimulates the thyroid gland to release thehormones thyroxine (T4) and triiodothyronine (T3) into the blood.

What does it mean when your TSH level is high?

It makes thyroid-stimulating hormone, or TSH, which tells the thyroid gland how much T4 and T3 to produce. The TSH level in your blood reveals how much T4 your pituitary gland is asking your thyroid gland to make. If your TSH levels are abnormally high, it could mean you have an underactive thyroid, orhypothyroidism.

What is the normal TSH level for thyroid?

The normal range of TSH levels is 0.4 to 4.0 milli-international units per liter. If you're already being treated for a thyroid disorder, the normal range is 0.5 to 3.0 milli-international units per liter. A value above the normal range usually indicates that the thyroid is underactive. This indicates hypothyroidism.

Can TSH test detect thyroid cancer?

Levels of TSH, which is made by the pituitary gland, may be high if the thyroid is not making enough hormones. This information can be used to help choose which imaging tests (such as ultrasound or radioiodine scans) to use to look at a thyroidnodule. The TSH level is usually normal in thyroid cancer.

Transaminase                                  Alanine (ALT)  1 - 21 units/L
                                                            Aspartate(AST) 7 - 27 units/L

The liver has transaminases to synthesize and break down amino acids and to convert energy storage molecules. The concentrations of these transaminases in the serum (the non-cellular portion of blood, also called plasma) are normally low. However, if the liver is damaged, the liver cell (hepatocyte) membrane becomes more permeable and some of the enzymes leak out into the blood circulation.

The two transaminases commonly measured are alanine transaminase (ALT) and aspartate transaminase (AST). These levels previously were called serum glutamate-pyruvate transaminase (SGPT) and serum glutamate-oxaloacetate transaminase (SGOT).

Elevated levels are sensitive for liver injury, meaning that they are likely to be present if there is injury. However, they may also be elevated in other conditions such as thyroid disorders, celiac disease, and muscle disorders.

ALT is usually found only in the liver. AST is most commonly found in the liver, but also in significant amounts in heart (cardiac) and skeletal muscle.

Measurement of ALT and AST were used in diagnosing heart attacks, although they have been replaced by newer enzyme and protein tests that are more specific for cardiac damage.

Possible causes for high ALT levels are liver inflammation (hepatitis A, B, C, infectious mononucleosis, acute viral fever, alcohol, pancreatic disorder), injury to muscles (trauma, myocardial infarction, congestive heart failure, acute kidney failure), and many toxins and drugs.

Urea nitrogen (BUN)                     7 - 18 mg/dL

The blood urea nitrogen test, which is also called a BUN or serum BUN test, measures how much of the waste product you have in your blood. If your levels are off the normal range, this could mean that either your kidneys or your liver may not be working properly.

What is a good bun level?

Results of the blood urea nitrogen test are measured in milligrams per deciliter (mg/dL) in the United States and in millimoles per liter (mmol/L) internationally. In general, around 7 to 20 mg/dL (2.5 to 7.1 mmol/L) is considered normal.

Uric Acid                                           3.0 - 7.0 mg/dL

The uric acid blood test is used to detect high levels of this compound in the blood in order to help diagnose gout. The test is also used to monitor uric acid levels in people undergoing chemotherapy or radiation treatment for cancer.

Vitamin A                                          30 - 65 ug/dL

This test measures levels of Vitamin A in the blood.  Vitamin A, also known as Retinol, is an essential nutrient for healthy skin, healthy eyes and vision, bone growth, immune function and embryonic development.  The body cannot produce Vitamin A so it must come from the food a person eats.  Deficiency of Vitamin A is rare in the United States but may occur in people who do not get enough meat, fruits and vegetables in their diet.  The most common symptom of Vitamin A deficiency is night blindness.  The primary causes of deficiency are malnutrition and malabsorption disorders such as Celiac Disease, Cystic Fibrosis, and Chronic Pancreatitis.  Vitamin A toxicity is typically due to the overuse of supplements but may also be caused by diets which include large amounts of foods such as liver which are high in Vitamin A. 

This test is typically ordered when a person has symptoms which are indicative of vitamin A deficiency such as night blindness, dry eyes, skin or hair, lesions on the skin, anemia, gray spots on the eye lining and repeated infections.  It may also be used to monitor people with conditions which cause vitamin deficiencies such as Celiac Disease and Crohns Disease.  Testing may also be ordered to check for Vitamin A toxicity.  Because the common symptoms of toxicity are similar to other conditions, this is usually done when a person has taken high levels of supplements or has a diet high in Vitamin A rich foods.

White Blood cell (WBC)                 4,300 - 10,800 cells/uL/cu mm

A white blood cell (WBC) count is a test that measures the number of white blood cells in your body. This test is often included with a complete blood count (CBC). The term “white blood cell count” is also used more generally to refer to the number of white blood cells in your body. There are several types of white blood cells, and your blood usually contains a percentage of each type. Sometimes, however, your white blood cell count can fall or rise out of the healthy range. 

WBCs, also called leukocytes, are an important part of the immune system. These cells help fight infections by attacking bacteria, viruses, and germs that invade the body. White blood cells originate in the bone marrow but circulate throughout the bloodstream. There are five major types of white blood cells:

• neutrophils
• lymphocytes
• eosinophils
• monocytes
• basophils

Having a higher or lower number of WBCs than normal may be an indication of an underlying condition. A WBC count can detect hidden infections within your body and alert doctors to undiagnosed medical conditions, such as autoimmune diseases, immune deficiencies, and blood disorders. This test also helps doctors monitor the effectiveness of chemotherapy or radiation treatment in people with cancer.

NORMAL RANGE

What is a normal WBC count?

An average normal range is between 3,500 and 10,500 white blood cells per microliter of blood (mcL). Infants are often born with much higher numbers of WBCs, which gradually even out as they age.

Age	White blood cells per mcL of blood
immediately after birth	9,000 to 30,000
1 to 7 days	9,400 to 34,000
8 to 14 days	5,000 to 21,000
15 days to 1 month	5,000 to 20,000
2 to 5 months	5,000 to 15,000
6 months to 1 year	6,000 to 11,000
2 years	5,000 to 12,000
3 to 5 years	4,000 to 12,000
6 to 11 years	3,400 to 10,000
12 to 15 years	3,500 to 9,000
adults	3,500 to 10,500

These normal ranges can vary by lab. Another common measurement for the volume of blood is cubic millimeter, or mm3. A microliter and cubic millimeter are the same amount.

The types of cells that make up WBCs usually fall within a normal percentage of your overall white blood cell count.

The normal percentages of the types of WBCs in your overall count are usually in these ranges:

Type of WBC	Normal percentage of overall WBC count
neutrophil	45 to 75 percent
lymphocyte	20 to 40 percent
eosinophil	less than 7 percent
monocyte	1 to 10 percent
basophil	less than 3 percent

Higher or lower numbers of WBCs than normal can be a sign of an underlying condition. Having a higher or lower percentage of a certain type of WBC can also be a sign of an underlying condition.

SYMPTOMS OF AN ABNORMAL COUNT

Symptoms of an abnormal WBC count

The symptoms of a low WBC count include:

• body aches
• fever
• chills
• headaches

High WBC counts don’t often cause symptoms, although the underlying conditions causing the high count may cause their own symptoms.

The symptoms of a low white blood cell count may prompt your doctor to recommend a WBC count. It’s also normal for doctors to order a complete blood count and check your WBC count during an annual physical examination.

PROCEDURE

What to expect from a WBC count

A healthcare provider or lab technician will draw blood to check your WBC count. This blood sample is taken either from a vein in your arm or a vein on the back of your hand. It only takes a couple of minutes to draw your blood, and you may experience minor discomfort. The healthcare provider will clean the needle site to kill any germs and then tie an elastic band around the upper section of your arm. This elastic band helps the blood fill your vein, making it easier for the blood to be drawn.

The healthcare provider slowly inserts a needle into your arm or hand and collects the blood in an attached tube. The provider then removes the elastic band from around your arm and slowly removes the needle. The technician will apply gauze to the needle site to stop the bleeding.

Healthcare providers use a different technique when drawing blood from young children and infants. With them, providers first puncture the skin with a lancet (a pricking needle) and then use a test strip or a small vial to collect the blood. Results are sent to a lab for review.

Having your blood drawn is a simple procedure, and complications are extremely rare. It can be difficult to take blood from people with small veins. The lab technician may be unable to locate a vein, or once the needle is inside the arm or hand, they may have to move the needle around in order to draw blood. This can cause a sharp pain or a stinging sensation.

Rare complications include:

• infection at the needle site
• excessive bleeding
• lightheadedness or fainting
• bleeding underneath the skin (hematoma)