Doctor’s Tip: Health fair lab results
There was a health fair in Carbondale on May 27, and Aspen Valley Hospital just put on fairs in Aspen and mid-valley. This column offers some tips to help participants to understand health fair lab results. It is not meant to take the place of discussing abnormal results with your primary care provider. Ideally, you should fast for at least six hours (Water’s okay) before having your blood drawn because failure to do so can affect blood sugar and triglyceride results.
VITAL SIGNS: Normal blood pressure is 120/80 or less. Normal BMI (body mass index) is 18.5 to 24.9 (plug your height and weight into a BMI calculator online). Another important vital sign that isn’t done at most health fairs but should be is waist circumference — taken at the point of maximum abdominal circumference — above the hips and belly button (not your belt size). Normal for women is < 35 inches and men < 40 inches, with lower cutoffs for Asians and East Indians.
CBC (COMPLETE BLOOD COUNT): Red blood cells carry oxygen, and hematocrit and hemoglobin are measures of your red blood count. Mildly elevated values suggest sleep apnea — your body compensates for low oxygen at night by making more red blood cells. Markedly elevated values indicate a more serious problem. A low red blood count is anemia, which can have many causes, but blood loss is the most common. In a young woman, heavy periods can be the reason for blood loss, but in middle-aged and older women and in men, blood loss from the GI tract from conditions such as bleeding ulcer, colon polyps or cancer needs to be ruled out. The standard range for WBC (white blood count) is 4.5 to 11, although some experts say this should be changed to 3 to 9 — levels > 9 indicate infection or inflammation, and people on a plant-based diet often have WBCs as low as 3 because they have minimal to no inflammation. A WBC < 3.0 could indicate bone marrow suppression and needs to be investigated. Also included in the CBC is a platelet count —small blood cells that cause blood to clot when you want it to; values that are borderline high or low are of no concern, but significantly high or low values need to be investigated.
CMP (COMPREHENSIVE METABOLIC PANEL): Most labs report any blood sugar less than 100 as normal, although any level above 92 indicates a problem with glucose metabolism. Creatinine and GFR are measures of kidney function. If creatinine is high or GFR < 60, chronic kidney disease is present. BUN is also a measure of kidney function but can be high with dehydration associated with fasting. ALT and AST are liver tests; the most common cause of elevation these days is fatty liver, although other problems such as hepatitis and cancer need to be ruled out.
LIPIDS include total cholesterol, HDL (good cholesterol), LDL (bad cholesterol), and triglycerides. Guidelines recommend a total cholesterol of 200; HDL of 40 or greater in a male or post-menopausal female, 50 or greater in premenopausal female; LDL of < 100; triglycerides of < 150. However, heart attack-proof levels are total cholesterol of < 150; LDL < 50; triglycerides < 70; non-HDL cholesterol < 100.
URIC ACID: If elevated you have a higher risk of developing gout and/or uric acid kidney stones.
A1C is a measure of your average blood sugar over the preceding 3 months. Normal is < 5.7, pre-diabetes is 5.7 to 6.4, and diabetes is 6.5 or greater.
PSA is an imperfect but useful blood test for prostate cancer. Any level above 4.0 is worrisome, as is an increase of 1 point in a year (e.g. 2.0 last year and 3.0 this year).
TSH: The thyroid is a gland in your neck that regulates your metabolism; for optimal health, the level of thyroid hormone should be within the normal range. TSH stands for thyroid stimulating hormone, secreted by the pituitary gland in the brain. A high TSH indicates hypothyroidism; a low level indicates hyperthyroidism.
VITAMIN D: Many people are low in vitamin D, and most authorities recommend that people of all ages take a supplement — the dose for adults is 2,000 units of D3 daily. If you are doing this, it’s not worth spending the money on a test.
STOOL TEST FOR COLON CANCER: Colon cancer is becoming more prevalent in younger people. If you’re age 30 or over, be sure to get this test if offered. If it isn’t offered, talk to your PCP about screening.
Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email email@example.com.
In honor of June being National Men’s Health Month, Laura Van Deusen and Center For Prevention are collaborating on a cooking class: Food For a Healthy Heart, 7 p.m. on June 22, Third Street Center in Carbondale. To sign up, contact Laura at 970-424-2175 or firstname.lastname@example.org.
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