Lab Tests and What They Mean

By Eileen Nauman, DHM (UK)
Copyright 2007-2013. All Rights Reserved.

Understanding Your Test Results

There are many types of tests, and the ones presented here are not necessarily the same ones found around the country. Some of the tests may differ. What may also differ is the “normal” range, and this causes the patient confusion. If you have any questions about these tests, simply ask your doctor to explain what is on your lab test or panel. If you want a specific one, or a panel, let’s say, you can certainly request it.

The 1st column lists the test name. The 2nd column lists test results which are within normal range. An “H” by the number in the 3rd column indicates your test result is higher than normal range, and an “L” indicates a test lower than normal. The next column lists the reference or normal range for your sex and age, and the last column lists the unit of measure for each test. If you have any test results that are outside of normal range, your test will be stamped, “Please review your test results with your physician.”

                 Within               Outside            Reference
Unit of
Test             Range                 Range               Range

The reference range may also be referred to as the recommended range. For example, the recommended range for total cholesterol is less than 200; however, the “average” range, for American’s, is higher than 200. “Average” does not mean “optimal.”

On your Chem Panel test results, refer to the section marked “CHD risk group.” This chart determines the calculated risk for developing coronary heart disease (CHD) based upon your “cholesterol/HDL” ratio.

The LDL cholesterol is the “bad guy” that clogs the arteries. The HDL cholesterol, or “helping” cholesterol, helps to clean out the arteries. The total cholesterol to HDL ratio compares how much your total cholesterol is made up of the “good” or HDL cholesterol. The lower the ratio, the lower your risk of developing coronary heart disease. An HDL reading above 60 helps protect the heart and blood vessels and an HDL below 35 is an independent risk factor.

Look for your “CHOL/HDL RATIO” above and compare your numbers to the risk ratio below. The average risk for developing coronary heart disease based on total cholesterol is HDL is 5.0 for MEN and 4.4 for WOMEN. if your ratio is in the moderate, high, or highest level, you have a grater risk of developing heart disease based on cholesterol level. If you received a Lipid Profile only, your test will have a “percent HDL and CHD risk group.” This risk is based on HDL alone. Refer to the “%HDL” reading above to see how you compare to the percent HDL for men and women.

If you have any abnormal readings, they will be printed in a box at the end of tests, listed as “values outside reference normal ranges.”

Remember, cholesterol level is only one of many risk factors involved in determining your risk for developing heart disease.  Work with your physician to help lower your risk by not smoking, following a low fat diet, exercising regularly and controlling diabetes and high blood pressure.

BUN/Creatinine Ratio
By comparing the BUN level in the blood to the creatinine level, the doctor can determine if the high BUN level is caused by a kidney problem or from something like blood loss.

Total Protein
This is a measure of the total amount of protein in your blood. A low or high total protein does flat indicate a specific disease, but it does indicate that some additional tests may be required to determine if there is a problem.

Approximately two-thirds of your blood circulating in your blood is albumin. This important protein inside your blood vessels. When your albumin level is too low, water can leak out of your blood vessels into other parts of your body and cause swelling. A low level of albumin in the blood can be caused by malnutrition, too much water in the body, liver disease, kidney disease, severe injury or major bone fractures, and slow bleeding over a long period of time.

This is the group of proteins in your blood that helps to fight infections. It is actually comprised of about 60 different important proteins. Some of the proteins in this group play an important role in blood clotting and unclotting. If your globulin level is abnormal, your doctor may want to measure some of the individual proteins that make up this group.

A simple way to tell it the albumin or globulin levels in the blood are abnormal is to compare the level of albumin to the level of globulin in your blood.

This element plays an important role in salt and water balance in your body. A low level in the blood can be caused by too much water intake, heart failure, or kidney failure. A lower level can also be caused by loss of sodium in diarrhea, fluid, or vomit. A high level can be caused by too much intake of salt or by not enough intake of water.

This element is found primarily inside of cells and its role is to maintain water balance inside the cells and help in the transmission of nerve impulses. Low or high levels in the blood may be found in patients on diuretics or in patients not receiving enough potassium. A low potassium level can cause muscle weakness and heart problems. A high potassium level can be found in kidney disease or in overuse of potassium supplements. Some “salt” substitutes contain potassium instead of sodium, and an excessive use of these substitutes can cause dangerously high levels of potassium in the blood.

Chloride is probably the least important element that is measured in the blood. It is almost never the only element that is high or low. It is usually associated with a high or low level of potassium or sodium. Borderline low or high levels of chloride have very little significance.

The body must have iron to make hemoglobin and to help transfer oxygen to the muscles. If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function up to par. On the other hand, if there is too much iron in the body, this can cause injury to the heart, pancreas, joints, testicles, ovaries, etc.

TIBC (Total Iron Binding Capacity)
Iron is transported in your blood bound to a protein called transferrin. Transferrin transports the iron in your body from the iron storage sites to where it is needed. It also transports the iron when not needed back to the storage sites. A low TIBC suggests malnutrition or iron excess. A high TIBC suggests and iron deficiency.

This indicates possible liver, heart or muscle disease. Vigorous exercise can elevate this level, as always, consult your physician with elevated results.

Liver function some as above. Confirmation should be made with second blood test.

Transferrin Percent Saturation
This percent is obtained by comparing the iron level to the TIBC level. It is a simple way to compare the amount of iron in the blood to the capacity of the blood to transport iron.

Cholesterol is an essential blood fat, but too high a level of this blood fat has been shown to be associated with a higher risk of heart disease and clogged blood vessels.

Cholesterol Percentile
This number helps to compare your cholesterol level to others of your age and sex. It tells you what percent of your peers have lower levels than you and provides some idea of the risk you have in developing heart disease.

HDL Cholesterol
High density lipoprotein (HDL) cholesterol is the “good” cholesterol. One of the important roles of HDL cholesterol in your body is to carry cholesterol away from your arteries to your liver. The more HDL cholesterol you have, the more cholesterol can be carried away and not clog your arteries.

Cholesterol/HDL Ratio
This number is obtained by comparing the total cholesterol level to the HDL cholesterol level. The higher this number, the greater the risk of coronary heart disease. A high HDL cholesterol level will result in a lower ratio, which means a lower risk. This could be true even if the total cholesterol level may be high. It is this ratio that appears to best measure the lipid associated risk of your developing heart disease.

This is a blood fat that may be related to a higher risk of heart disease.

This element is found primarily inside the cells of the body. A low magnesium level in the blood may indicate severe malnutrition, severe diarrhea, alcoholism, or excessive use of diuretics. A very low level of magnesium in the blood can cause your muscles to tremble.

Total Bilirubin
Bilirubin is a pigment in the blood that makes the plasma or serum part of your blood yellow. When the Bilirubin level in the blood is very high for a period of time, the whites of your eyes and your skin may become yellow….this is known as jaundice. Bilirubin comes from the breakdown of old red cells in the blood. A high Bilirubin level in the blood can be caused by too many red cells being destroyed (hemolysis), by liver disease, or by a blockage of bile ducts. Fasting can also cause a slight increase in total Bilirubin.

Direct Bilirubin
This is a specific form a of Bilirubin that is formed in the liver and excreted in the bile. Normally very little of this form of Bilirubin is found in the blood. However, in liver disease some of this form of Bilirubin leaks into the blood so even a slightly higher level of direct Bilirubin indicates a problem with the liver cells.

Alkaline Phosphatase
Alkaline Phosphatase is an enzyme (an enzyme is a catalyst that is needed for a specific chemical reaction to take place in your body) that is found in all body tissue, but the most important sites are bone, liver, bile ducts and gut. A high level of alkaline Phosphatase in your blood may indicate bone, liver or bile duct disease. Certain drugs may also cause high levels. Growing children, because of bone growth, normally have a higher level than adults.

Gamma-Glutamyltansferase (GGT)
This is an enzyme that is primarily found in the liver. Drinking too much alcohol, certain drugs, liver disease and bile duct disease can cause high levels of GGT in the blood.

Transminase AST
The AST enzyme is found mainly in the heart, liver and muscles. High levels of AST in the blood sugar suggest a problem with either the heart, liver or muscles.

Transaminase, ALT
The ALT enzyme is found mainly in the liver. If the level of ALT in your blood is high, your doctor may call you back to have it repeated on another blood sample.

Lactate Dehydrogenase (LDH)
LDH is an enzyme found in all tissues in the body so that a high level in the blood can result from a number of different diseases. Also, slightly elevated levels in the blood are common and usually do not indicate disease. The most common sources of LDH are the heart, liver, muscles and red blood cells.

BUN (Blood Urea Nitrogen)
BUN is a waste product derived from protein breakdown in the liver. It is excreted by the kidneys. When your kidneys are not working well, the level of BUN in the blood will rise. Dehydration and blood loss can also cause a high BUN level. A low BUN level may be a cause of liver disease, a low protein diet, or too much water intake.

The blood concentration of creatinine depends upon two things: the amount of muscle you have and the ability of your kidneys to execute the creatinine. High levels of creatinine in the blood usually indicate a deterioration in the kidney function.

This is the chief source of energy for all living organisms. A high blood glucose, in someone who has fasted for 12 hours, suggests diabetes, and the doctor may wish to do some further testing. A low glucose level may mean too much insulin in your blood.

Protein Bound Glucose (PBG)
This new test measures the amount of glucose that circulates in your blood bound to protein. PBG levels provide an indication of your average blood glucose level over the preceding 7 to 15 days, and help to confirm the glucose result you have today. The combination of the PBG result and the glucose result provide a much better indication of your body’s glucose metabolism than either test alone.

Uric Acid
Uric acid is the end product of the breakdown of purines in your body. Purines are an important component of proteins. A high level of uric acid in your blood may cause gouty arthritis or kidney stones. The level of uric acid in the blood is affected by a rich diet of purines–food such as kidney, liver, pancreas and sweetbreads (brains). Also, stress, alcohol and certain diuretics may raise the level.

Phosphate is closely associated with calcium in bone development. Therefore, most of the phosphate in the body is found in the bones. But the phosphate level in the blood is very important for muscle and nerve function. Very low levels of phosphate in the blood can be associated with starvation of malnutrition and this can lead to muscle weakness. High levels in the blood are usually associated with kidney disease.

Calcium is one of the most important elements in the body. Nine-nine percent of the calcium in the body is in the bones–only one percent is outside the bones. But that one percent is very important for the proper function of nerves, enzymes, muscles, and blood clotting. Low levels of calcium in the blood are association with malnutrition. High levels can be caused by bone disease, excess intake of antacids and milk (this is often seen in people with ulcers) excess intake of Vitamin D, and hyperparathyroidism. The parathyroid gland is in the main regulator of calcium in the body (and 4 pea size glands sit within the thyroid gland in our neck region).

PSA – Understanding Your Prostate Specific Antigen Test Results


			            Outside             Within
                Test                Range               Range
Normal      Prostate Specific                            2.0
0.0 to 4.0
Reading         Antigen
Abnormal    Prostate Specific
Reading:        Antigen             8.0
0.0 to 4.0

The prostate gland, found only in males, is a component of the male reproductive system. PSA is a protein unique to the prostate gland and is detected in the blood serum. High levels indicate problems with the prostate ranging from acute inflammation to prostate cancer. Abnormal low levels are not a problem.

If your test result is between the 0.0 to 4.0 range, then you fall in the “normal” or reference range and will appear in the pink column. The prostate specific antigen may be elevated due to a number of conditions. If your test result is elevated, be sure to follow up with your doctor.


Hypothyroid Panel

Thyroxine (T4)
T3 Uptake
FT1 (T7)

Also known as the “T3, T4, and T7” test. (For better understanding, also order the TSH test, a blood test, which tests the pituitary gland to see if it is putting out the hormone to trigger the thyroid to release its hormones. Both tests should be done.)

Thyroid Stim Hormone
This measures the level of a hormone which stimulates the thyroid gland to produce thyroid.

T4 (Thyroxine)
Thyroxine is a thyroid hormone. This hormone controls your rate of metabolism. A low level of thyroxine suggests hypothyroidism or myxedema. A high level of thyroxine suggests hyperthyroidism or thyrotoxicosis.

T3 Uptake
Evaluates the quantity of Thyroxine-binding globulin CTGB present
in the serum and the quantity of T4 bound to it.

T7 index is simply a T4 plus T3.

If either your thyroid blood levels, or your thyroid stimulating hormone are outside of the reference range, please take your test to your physician for follow up.

Chempanel Test

Test 					      Related to:
Glucose					Diabetes
BUN						Kidney function
Creatinine					Hypertension
BUN/Creatinine Ratio			Renal (Kidney) disease
Alkaline Phosphatase			Bone function
GGTP						Liver function
Total Bilirubin
Total Protein
Albumin					Nutritional status
A/G ratio
Cholesterol					Coronary risk
Triglyceride					Cardiovascular
LDL Cholesterol				Disease risk
HDL Cholesterol
VLDL Cholesterol
Total Cholesterol: HDL Ratio
Percent HDL Cholesterol
Iron						Iron status


CBC – Complete Blood Count

The following lists explains the abbreviations of the CBC and the relation of each measure to specific conditions:

							Related to:
WBC   White blood count	                  Infection/lowered
                                            immune system
RBC    Red blood count			      Anemia
MCV    Mean Corpuscular volume              Red blood cell index
MCH    Mean Corpuscular Hemoglobin
MCHC   Mean Corpuscular Hemoglobin Concentration
RDW    Random Distribution Width
       Platelet Count			      Coagulation (clotting)
       Neutrophils				      Infection

The CBC is a complex test and requires physician diagnosis for any specific conditions. If you have abnormal values, we recommend following up with your physician.


Diabetes Checklist

Adapted from ADA Medical Standards of care.

If you have diabetes, do you:

1. Have your EYES checked annually for retinopathy?
2. Have your FEET checked at each physician’s visit
(looking for poor circulation, possible gangrenous condition manifesting)?
3. Check your blood glucose levels at home regularly?
4. Have an updated individualized meal plan?
5. Have an exercise prescription?
6. Know your current A1C level?

If you answered NO to any of these questions you need to talk with your physician about the American Diabetes Association Standards of Medical Care.