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Table of Contents

Lab Values

Na+ (N=135-145 mmol/L; BH=141 mmol/L)(1) The level of sodium that is present in the blood or urine is measured using this test (2). This test can be used to monitor patients that are taking medications that can affect the sodium levels, such as diuretics (2). It is also used to see whether or not a person with high blood pressure is consuming too much salt (2). This test is ordered when patients have symptoms of hyponatremia, which include weakness, confusion, and lethargy, or symptoms of hyperatremia, which include decreased urinary output, thirst, and muscle twitching (2). Hyponatremia may be due to Addion’s disease, diarrhea, diuretic administration or kidney disease (2). Hyperatremia is usually due to inadequate water intake and dehydration (2). Decreased urinary sodium levels may be indicative of dehydration, liver disease, or CHF, whereas increased urinary sodium levels may be indicative of diuretic use or Addison’s disease (2).

K+ (3.5-5 mmol/L; BH=4.3 mmol/L) (1). This test is used to detect potassium concentrations that are too high (hyperkalemia) or too low (hypokalemia) (2). The most frequent cause of hyperkalemia is due to kidney disease (2). This test is usually routinely performed in most patients that have any type of serious illness. Increases in serum potassium levels can be due to acute or chronic kidney failure, diabetes, dehydration, infection and Addion’s disease (2). Decreased levels can be due to acetaminophen overdose, diuretic use, and gastrointestinal disorders that are associated with diarrhea and vomiting (2).

Ca2+ (N= 2.2-2.6 mmol/L; BH = 2.3 mmol/L) (1). This test is done to measure the amount of calcium that is present in the urine and the blood (2). This can be used as a diagnostic test if a patient has symptoms that suggest kidney stones, bone disease and or neurologic disorders (2). Kidney failure usually manifests with low calcium (2). Symptoms of too much calcium may include fatigue, weakness, loss of appetite, nausea, vomiting, constipation and abdominal pain (2). Low calcium is associated with abdominal cramps, muscle cramps or tingling fingers (2). Cancer is associated with elevated levels of calcium (2). This is because when cancer spreads to the bones, it causes the release of calcium from the bone into the blood (2). It may also produce a hormone that acts similarly to PTH resulting in increased calcium levels (2).

Cl- (N= 95-105 mmol/L; BH= 99 mmol/L) (1). Chloride testing is used to help determine the cause of signs and symptoms such as prolonged vomiting, diarrhea, weakness, and respiratory distress (2). Hyperchloremia usually is indicative of dehydration, but can occur with other conditions such as Cushing syndrome or kidney disease (2). It also occurs when the patient hyperventilates (2). Hypochloremia occurs along with any disorder that results in low blood sodium. It can also occur with congestive heart failure, prolonged vomiting or gastric suction, and other chronic lung diseases that cause respiratory acidosis (2).

CO2 (N= 21–30 mmol/L; BH: 23 mmol/L) (1). This test is ordered when there is worsening symptoms of acid/base imbalance, difficulty in breathing, or shortness of breath (2). It can also be used to assess the effectiveness of supplemental oxygen therapy (2). Results that are abnormal can indicate that the patient is either not getting rid of enough carbon dioxide or there is a concern with the renal function (2).

BUN (N=3.6-7.1 mmol/L; BH: 4.9 mmol/L) (1). This test is used alone with the serum creatinine test to help evaluate the kidney function in a patient (2). It is used to monitor acute or chronic kidney dysfunction or failure (2). Increased levels of BUN are indicative of impaired kidney function (2). Various causes could be acute or chronic kidney disease, damage, or failure (2). It may also be due to conditions that reduce the amount of blood flow to the kidneys, such as congestive heart failure, shock, or recent heart attack (2).

Serum Creatinine (N=70-120 µmol/L males; BH = 111 µmol/L) (1). This test is used to assess the function of the kidneys (2). It is ordered when the doctor suspects that the kidneys are not functioning properly (2). Common signs and symptoms of kidney dysfunction include fatigue, poor concentration, trouble sleeping, swelling or puffiness, urine that is foamy, a decrease in the amount of urine or high blood pressure (2). Increased levels of creatinine may suggest damage or swelling of blood vessels in the kidneys, bacterial infection of the kidneys, kidney stones or reduced blood flow to the kidneys (2) . Glucose (N=4-7 mmol/L; BH = 5.7 mmol/L) (1).This test is to screen for hyperglycemia, or hypoglycemia and can be used to help diagnose diabetes or monitor glucose levels in patients that already have diabetes (2). High levels of glucose most commonly indicate diabetes, but other diseases can also elevate the glucose levels such as Cushing syndrome, chronic kidney failure, hyperthyroidism, pancreatic cancer and pancreatitis (2).

Hbg (N=120-180 g/L; BH = 132 g/L) (1). This test is to measured the severity of anemia or polycyhemia that may be present (2). It is also mainly used to make decisions about blood transfusions if the anemia is severe enough (2). Below normal levels suggest cirrhosis of the liver, deficiencies such as B12, folate and iron, cancers that affect the bone marrow, kidney disease and excessive bleeding (2).

Hct (N = 0.41-0.53; BH=0.40) (1).This test is used to evaluate anemia, polycythemia, dehydration, and response to the treatment of anemia or polycythemias (2). Low levels of hemtocrit can indicate anemia that may be due to iron deficiency or other deficiencies (2). The most common cause of increased hematocrit is dehydration and with adequate hydration, the hematocrit levels will return to normal (2).

Ferritin (N= 30–300 μg/L; BH=143 μg/L ) (1). This test is used to determine the iron stories in a patient’s body (2). It can be used to detect iron deficiency anemia, which includes symptoms of chronic fatigue, weakness, dizziness, and headaches (2). It can also be used to detect iron overload, which may include symptoms such as joint pain, lack of energy, abdominal pain, and loss of sex drive (2).

WBC (N=4.5-11×109/L; BH = 9.4 x 109/L) (1). This test assesses the levels of white blood cells in the body. It can be used to determine the presence of an infection or leukemia. It can also monitor the body’s response to treatments and to monitor bone marrow function. Leukocytosis refers to elevated number of white blood cells and this can be due to bacterial infections, inflammation, leukemia and or trauma. Decreased white blood cell counts is called leucopenia and may be due to chemotherapy, radiation therapy or diseases of the immune system.

ANC (N=2500-6000/ mm3; BH = 3500/mm3) (1). This test is known as the absolute neutrophil count and it measure the amount of neutrophils that are present in the body (2). These cells increase in response to bacterial infection of inflammatory disease (2). However, severe elevations may be due to bone marrow disorders such as chronic myelogenous leukemia (2). Decreased levels may be due to responses to various medications such as chemotherapy (2). When the ANC is <500, this is indicative of neutropenia (2).

Neutrophils (N= 0.4-0.7; BH =0.58) (1). See ANC. Neutrophils are the most common white blood cells and will increase during bacterial and fungal infections (2).

Bands (N=0-0.10; BH=0.07) (1). Bands are immature neutrophils (2). These are present in the circulation in small numbers (2). When there is an increased, the bands will be considered to have a left shift and factors that may contribute to this include acute infections that increase neutrophil production (2). This causes a premature release before they can mature into the neutrophils (2). Lower amounts of bands suggest that the immune system is suppressed (2).

Lymphocytes (N=0.22-0.44; BH =0.22) (1). Lymphocytes occur as B cells that produces the antibotides, or as T cells that recognizes foreign substances and tags them for removal (2). These are increased in some leukemias and decreased in diseases that suppress the immune system, such as HIV (2).

Monocytes (N=0.04-0.11; BH=0.05) (1). Increases in monoycyte levels are due to infection of all kinds and inflammatory disorders (2). They are also increased in malignant disorders that include leukemia (2). Decreased levels could be due to bone marrow injury and some forms of leukemia as well (2).

Eosinophils (N=0-0.08; BH=0.01) (1). Eosinophils increase in response to allergic disorders, parasitic infections and inflammation of the skin (2). They also increase in response bone marrow disorders. Decreased levels may be due to infections (2).

Basophils (N=0–0.03; BH=0.01) (1). This type of cell increases in chronic inflammation, radiation therapy, hypersensitivity reactions and leukemia (2).

Platelets (N=130-400 x 109/L; BH = 264 x 109/L) (1). If the platelet levels fall below 20,000 per microliter, this means that spontaneously bleeding may occur, which poses a life threatening risk (2). Patients that have bone marrow disease, or leukemia, or another cancer in the bone marrow may experience excessive bleeding due to a decreased number of platelets (2). When the number of cancer cells increase in bone marrow, the normal bone marrow cells become crowded out and there is less platelet producing cells (2).

AST (N=0-35 U/L; BH=28 U/L) (1). This test is for aspartate aminotransferase and is used to detect liver damage (2). This test is ordered when patient has signs of jaundice, dark urine, light colored stool, itching, nausea, vomiting and loss of appetite (2). Very high levels of AST are usually due to acute hepatitis (10 X ULN) which is mostly caused by viral infections. Some medications can elevate the AST levels as well (2).

ALT (N=0-35 U/L; BH= 26 U/L) (1). This test measures alanine aminotransferase in the blood, which is usually used to detect liver injury (2). Elevated levels of ALT that are more than 10 times the ULN may be suggestive of acute hepatitis (2). These ALT levels will stay high for about 1-2 months and then return to normal (2). These levels may be elevated due to drugs or other substances that are toxic to the liver (2).

ALK (N=30-120 U/L; BH= 109 U/L) (1). Alkaline phosphate is an enzyme that is present is several tissues throughout the body, including the liver, bone, kidney, and the intestines (2). The highest concentrations are in the bone and the liver. Thus, this test is used to detect liver or bone disease (2). A condition that affect bone growth or increases the activity of bone cells can affect ALP levels in the blood and thus can be used to detect cancers that have spread to the bone (2). High levels of ALP indicate that the liver has been damaged or increased bone cell activity has been increased (2).

GGT (N 1-94 U/L; BH = 58 U/L) (1). This test detects Gamma-glutamyl transferase levels in the blood (2). This can be helpful in determining the cause of an elevated ALK (2). Both the ALP and the GGT are elevated in diseases that are of bile duct or liver in origin, however only ALP will be elevated in bone disease (2). GGT is increased in diseases that cause acute damage to the liver or bile ducts. It is not helpful in distinguishing the causes of liver damage however (2).

Bilirubin-total (N=5.1–17.0 μmol/L; BH= 16 μmol/L) (1). High levels of bilirubin are usually associated with jaundice (2). Elevated bilirubin levels are due to the inability of the liver to adequately remove bilirubin in a timely manner (2). This may be due to a blockage of bile ducts, and liver diseases such as cirrhosis or acutehepatitis (2). It may also be due to inherited problems with bilirubin processing (2). Bilirubin levels are used to identify liver damage or disease (2). High levels of unconjugated bilirubin may be due to hemolytic, sickle cell, or pernicious anemia (2). If the conjugated bilirubin is elevated, it may be due to blockage of the liver or bile ducts, hepatitis, or trauma to the liver (2).

Albumin (N=35-55 g/L; BH=38 g/L) (1). Low levels of albumin suggest liver disease (2). This test is ordered with other liver enzyme tests to determine whether or not liver disease is present and what type of liver disease it is (2). Low levels can also be seen in inflammation, shock, malnutrition, celiac disease, Crohn’s disease and diseases in which the kidneys cannot prevent albumin from leaking blood into the urine and being loss (2). High albumin levels may be indicative of dehydration (2).

INR (N=1-2; BH=1) (1). The International Normalized Ratio is used to monitor the effectiveness of anticoagulant therapy (2). This test measure the time for it takes for the blood to clot and compares it to an average (2). The higher the INR, the longer it will take for the blood to clot (2). This means that the blood is thinner (2). Lower INRs indicate that the blood is thicker and thus the time to clot will be shorter (2).

References

  1. McQueen, M.J. Laboratory Reference Intervals: SI and Traditional Units. In: Compendium of Pharmaceuticals and Specialties [online version (e-CPS)]. Ottawa: Canadian Pharmacists Association; 2005 [cited 2012 Jan 27]. Available from: URL: http://e-cps.pharmacists.ca/CPHA/main.htm
  2. American Association for Clinical Chemistry. Lab Tests Online [Internet]. 2001 [updated 2011 Sep 12]. Available from: http://www.labtestsonline.org

Disclaimer

This information is presented for informational purposes only and is not meant to be a substitute for advice provided by qualified health care professionals. You should contact your qualified health care provider if you have or suspect any health problems. This article is not intended to provide medical advice for its readers


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