How To Interpret Lab Test Results
For these sites, you will order a test, obtain the requisition form, and go to any lab testing facility in your area to have your blood drawn.
- Life Extension Foundation
- Private MD Labs
- Discounted Labs
- Lab Corp
- Quest Diagnostics
- Direct Labs
- Any Labs Test Now
Important Panels for Men’s Health
- Endocrine Function (hormones)
- Lipid Panel (cardiac risk)
- Complete Blood Count (CBC for hematology)
- Complete Metabolic Panel (electrolytes, renal and liver function)
- Iron Panel and Vitamins
A full hormonal panel includes androgens and adrenal hormones, a complete thyroid panel, and hormones involved with metabolism such as cortisol and insulin.
Androgen – Lab Values for Adult Males:
- Total Testosterone: 348-1197 ng/dl
- Free Testosterone: 8.7-25.1 pg/ml
- LH: 6.0-19.0 mIU/ml
- FSH: 4.0-10.0 mIU/ml
- Estradiol: 8-35 pg/ml (Sensitive, LC/MS)
- PSA: <4.0 ng/ml
- DHEA-S: 160-449 ug/dl
- DHT: 106-719 pg/ml
- SHBG: 16.5-55.9 nmol/L
- IGF-1: 109-307 ng/ml
- Prolactin: 2.0-18.0 ng/ml
Thyroid – Lab Values for Adult Males:
- TSH: 0.3-3.0 uIU/ml
- Total T4: 4.5-12 mcg/dl
- Total T3: 80-200 ng/dl
- Free T4: 0.82-1.77 ng/dl
- Free T3: 2.0-4.4 pg/ml
- RT3: 9.2-24.1 ng/dl
- TPOAb: 0-34 IU/ml
- TgAb: 0-40 IU/ml
- TSI: < 1.4
Metabolic – Lab Values for Adult Males:
About 95% of the circulating Testosterone in a man’s body is formed by the Leydig cells, which are found in the testicles. A very small amount of testosterone secreted by the adrenal glands (in which the majority is made from the adrenal conversion of androstenedione to Testosterone via 17-beta HSD enzyme whose function is steroidogenesis).
LH is a glycoprotein that’s secreted by the anterior pituitary gland and is responsible for signaling the leydig cells to produce Testosterone. Measuring LH can be very useful in terms of determining whether a hypogonadic state (low Testosterone) is caused by the testicles not being responsive despite high or normal LH levels (primary), or whether it’s the pituitary gland not secreting enough LH (secondary). Of course, the hypothalamus, which secretes LH-RH (luteinizing hormone releasing hormone), could also be the culprit, as well as perhaps both the hypothalamus and the pituitary.
If it’s a case of the testicles not being responsive to LH, then things like clomiphene and hCG really won’t help. If the problem is secondary, then there’s a better chance for improvement with drug therapy. Increased levels can be indicative of hypogonadism, precocious puberty, and pituitary adenoma. Decreased levels can be indicative of pituitary failure, hypothalamic failure, stress, and malnutrition.
FSH regulates the development, growth, pubertal maturation and reproductive processes of the human body. In males, FSH induces production of androgen-binding proteins and is critical to spermatogenesis. High FSH levels are indicative of testicular failure, an autoimmune disease known as lupus, infertility, chromosomal irregularities, etc. Conversely, low FSH levels are indicative of suppressed hypothalamic or pituitary activity, high prolactin levels, hypogonadism, among other things.
With this being the most potent of the estrogens, it can be responsible for things like water retention, hypertrophy of adipose tissue, gynecomastia, and perhaps even prostate hypertrophy and tumors. As a male it’s very important to get your levels of this hormone checked for the above reasons. Also, it’s the primary estrogen that’s responsible for the negative feedback loop which suppresses endogenous testosterone production. So, if your levels of estradiol are rather high, you’ll be hypogonadal as well.
Increased estradiol levels can be indicative of a testicular tumor, adrenal tumor, hepatic cirrhosis, necrosis of the liver, hyperthyroidism, etc.
Prostate-specific antigen, or PSA, is a protein produced by cells of the prostate gland. This test is used to screen for the risk of prostate cancer, in which elevated results indicate that a biopsy, or at least close monitoring, may be needed. Fluctuations in PSA levels may be caused by a variety of factors. Increased PSA levels may indicate high estradiol levels, prostatitis, urinary tract infection, or prostate cancer, while certain drugs lower PSA.
PSA should be tested to screen for existing prostate cancer before starting Testosterone Replacement Therapy. TRT, however, does not cause prostate cancer.
This test is used to evaluate adrenal function and to distinguish DHEAS-secreting conditions that are caused by the adrenal glands from those that originate in the testicles. An elevated DHEAS may indicate an adrenocortical tumor, Cushing disease, adrenal cancer, or adrenal hyperplasia, or rarely a DHEAS-producing ovarian tumor. A low level of DHEAS may be due to adrenal insufficiency, adrenal dysfunction, Addison disease, or hypopituitarism, a condition that causes low levels of the pituitary hormones that regulate the production and secretion of adrenal hormones.
People taking DHEA supplements will have elevated blood levels of DHEAS. Certain antidiabetic drugs (such as metformin and troglitazone), prolactin, danazol, calcium channel blockers, and nicotine may also increase DHEAS levels. Drugs/hormones that may decrease DHEA-S levels include insulin, oral contraceptives, corticosteroids, dopamine, hepatic enzyme inducers (carbamazepine, imipramine, phenytoin), fish oil, and vitamin E. It is important to inform your healthcare provider when taking any of these products.
DHT is a potent form of testosterone required for male sexual development. However, aging men tend to have higher levels of DHT that could lead to problems such as hair loss and prostate dysfunction. As with testosterone, it is responsible to maintain bone density, fat distribution, muscle strength and mass, red blood cell production, sex drive and sperm production.
DHT is three times more potent than testosterone and is crucial to maintaining masculine characteristics and mitigating the effects of estrogen in men. Low levels of DHT may cause low libido.
SHBG is a protein that is produced by the liver and binds tightly to testosterone, DHT, and estradiol. In this bound state, it transports them in the blood as a biologically inactive form. The amount of SHBG in circulation is affected by age and sex, by decreased or increased testosterone or estrogen production, and can be affected by certain diseases and conditions such as liver disease, hyperthyroidism or hypothyroidism, and obesity.
Changes in SHBG levels can affect the amount of testosterone that is available to be used by the body’s tissues. Normally, about 40% to 60% of testosterone is bound to SHBG, with most of the rest weakly and reversibly bound to albumin, the main protein in the blood. Only about 2% is immediately available to the tissues as free testosterone.
A total testosterone test does not distinguish between bound and unbound testosterone but determines the overall quantity of testosterone. In many cases, this is sufficient to evaluate excessive or deficient testosterone production. However, if a person’s SHBG level is not normal, then the total testosterone may not be an accurate representation of the amount of testosterone that is available to the person’s tissues.
Also known as Somatomedin C, IGF-1 is a hormone that, along with human growth hormone (HGH), helps promote normal bone and tissue growth development. IGF-1 is produced in the liver and skeletal muscle and many tissues in response to HGH stimulation. Unlike HGH, IGF-1 tends to be stable while mirroring HGH deficiencies or excesses.
This test is used to evaluate growth hormone deficiencies, pituitary function, and to follow up on abnormal results on other hormone levels. Excessively high IGF-1 are usually caused by pituitary tumors and/or high HGH levels. Low IGF-1 is usually due to a HGH deficiency or decreased pituitary function, nutritional deficiencies (including anorexia nervosa), chronic kidney or liver disease, inactive/ineffective forms of HGH, and with high doses of estrogen.
Reduced pituitary function may be due to inherited defects or can develop as a result of pituitary damage following conditions such as trauma, infections, and inflammation.
Prolactin is a hormone produced by the anterior portion of the pituitary gland, a grape-sized organ found at the base of the brain. Prolactin secretion is regulated and inhibited by dopamine. Normally present in low amounts in men. This test is to help diagnose the cause of decreased libido, erectile dysfunction, and/or nipple discharge. It is also used to detect and monitor a prolactin-producing pituitary tumor (prolactinoma), and/or to follow up on a low testosterone test result in men.
A common cause of an abnormally elevated prolactin level is a prolactinoma, a tumor of the pituitary gland that causes excess production of prolactin. Prolactinoma is the most common type of pituitary tumor and is usually benign.
If the anterior pituitary gland and/or the tumor enlarge significantly, it can put pressure on the optic nerve, causing headaches and visual disturbances, and it can interfere with the other hormones that the pituitary gland produces. In men, these tumors can cause a gradual loss in sexual function and libido. If left untreated, prolactinomas may eventually damage the surrounding tissues.
Measuring the level of TSH can be very helpful in terms of determining if the problem resides with the thyroid itself or the pituitary gland. If TSH levels are high, then it’s merely the thyroid gland not responding for some reason but if TSH levels are low, it’s the hypothalamus or pituitary gland that has something wrong with it. The problem could be a tumor, some type of trauma, or an infarction.
Drugs that can increase levels of TSH include lithium, potassium iodide and TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine, T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and congenital cretinism. Decreased levels are indicative of hypothyroidism (pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.
T3 is the more metabolically active hormone out of T4 and T3. When levels are below normal it’s generally safe to assume that the individual is suffering from hypothyroidism. Drugs that may increase T3 levels include estrogen and oral contraceptives. Drugs that may decrease T3 levels include anabolic steroids/androgens as well as propanolol (a beta adrenergic blocker) and high dosages of salicylates. Increased levels can be indicative of Graves disease, acute thyroiditis, pregnancy, hepatitis, etc. Decreased levels can be indicative of hypothyroidism, protein malnutrition, kidney failure, Cushing’s syndrome, cirrhosis, and liver diseases.
T4 is just another indicator of whether or not someone is in a hypo or hyperthyroid state. It is rather reliable but free thyroxine levels should be assessed as well. Drugs that increase or decrease T3 will, in most cases, do the same with T4. Increased levels are indicative of the same things as T3 and a decrease can be indicative of protein depleted states, iodine insufficiency, kidney failure, Cushing’s syndrome, and cirrhosis.
Since only 1-5% of the total amount of T4 is actually free and useable, the free T4 test is a far better indicator of the thyroid status of the patient. An increase indicates a hyperthyroid state and a decrease indicates a hypothyroid state. Drugs that increase free T4 are heparin, aspirin, danazol, and propranolol. Drugs that decrease it are furosemide, methadone, and rifampicin. Increased and decreased levels are indicative of the same possible diseases and states that are seen with T4 and T3.
Reverse T3 (RT3) is a biologically inactive form of T3. Normally, when T4 is converted to T3 in the body, a certain percentage of the T3 is in the form of RT3. When the body is under stress, such as during a serious illness or in an overtrained state, thyroid hormone levels may be outside of normal ranges even though there is no thyroid disease present. RT3 may be elevated in non-thyroidal conditions, particularly the stress of illness.
Thyroid autoantibodies are antibodies that develop when a person’s immune system mistakenly targets components of the thyroid gland or thyroid proteins, leading to chronic inflammation of the thyroid (thyroiditis), tissue damage, and/or disruption of thyroid function. Laboratory tests detect the presence and measure the quantity of specific thyroid autoantibodies in the blood.
The thyroid is a small, butterfly-shaped gland that lies flat against the windpipe in the throat. The primary hormones that it produces, T4 and T3, are vital in helping to regulate the rate at which the body uses energy (metabolism). The body uses a feedback system in which thyroid stimulating hormone (TSH) stimulates the thyroid to produce T4 and T3 as needed. This system helps maintain a relatively stable amount of the thyroid hormones in the blood. When thyroid antibodies interfere with this process, they can lead to chronic conditions and autoimmune disorders associated with hypothyroidism or hyperthyroidism, such as Hashimoto thyroiditis or Graves disease, respectively.
Testing for thyroid antibodies, such as thyroid peroxidase antibody (TPO), is primarily ordered to help diagnose an autoimmune thyroid disease, such as Hashimoto thyroiditis, and to distinguish it from other forms of thyroid dysfunction. Thyroglobulin antibody (TGAb) targets thyroglobulin, the storage form of thyroid hormones. Thyroid stimulating immunoglobulin (TSI) binds to receptors and promotes the production of thyroid hormones, leading to hyperthyroidism, or Graves disease.
Insulin testing has several possible uses. Insulin is a hormone that is produced and stored in the beta cells of the pancreas. Insulin helps transport glucose, the body’s main source of energy, from the blood to within cells. If a person makes too little insulin or is resistant to its effects, cells starve. If someone makes too much, as may happen with an insulin-producing tumor (insulinoma) for example, then symptoms of low blood glucose (hypoglycemia) emerge.
Insulin testing may be used to help diagnose an insulinoma, diagnose the cause of hypoglycemia, identify insulin resistance, monitor the amount of insulin produced by the beta cells in the pancreas, determine when a type 2 diabetic might need to start taking insulin to supplement oral medications.
Elevated insulin levels are seen with, acromegaly, Cushing syndrome, corticosteroid use, fructose or galactose intolerance, insulinomas, obesity, or insulin resistance, such as appears in type 2 diabetes and metabolic syndrome. Decreased insulin levels are seen with diabetes, hypopituitarism, pancreatic diseases such as chronic pancreatitis (including cystic fibrosis) and pancreatic cancer.
Cortisol is a vital hormone, produced by the adrenal glands and regulated by the hypothalamus and pituitary, that plays a role in the metabolism of proteins, lipids, and carbohydrates, among other functions. Normally, the level of cortisol in the blood rises and falls in a “diurnal variation” pattern, peaking early in the morning, then declining throughout the day and reaching its lowest level about midnight. When the blood cortisol level falls, the hypothalamus releases corticotropin-releasing hormone (CRH), which directs the pituitary gland to produce ACTH (adrenocorticotropic hormone). ACTH stimulates the adrenal glands to produce and release cortisol.
The best way to test cortisol is to use a 4-point saliva or serum blood test at different times of the day, starting in the morning upon waking up and at night before bed. The cortisol test may be used to help diagnose Cushing syndrome, a condition associated with excess cortisol. Other symptoms associated with high cortisol include high blood pressure, high blood glucose, obesity, dry and fragile skin, purple streaks on the abdomen, muscle wasting and weakness, and osteoporosis.
The test is also used to help diagnose adrenal insufficiency or Addison disease, conditions associated with deficient cortisol. Symptoms associated with low cortisol include weight loss, muscle weakness, fatigue, low blood pressure, abdominal pain, or dark patches of skin.
Sometimes decreased production combined with a stressor can cause an adrenal crisis that can be life-threatening and requires immediate medical attention. Symptoms of a crisis may include: sudden onset of severe pain in the lower back, abdomen, or legs, vomiting and diarrhea, resulting in dehydration, low blood pressure, or loss of consciousness.
Used to determine possible risk for coronary and vascular disease. In other words, heart disease.
Lab Values for Adult Males:
- Total Cholesterol: 120-200 mg/dl
- HDL: >39 mg/dl
- LDL: <100 mg/dl
- VLDL: 5-40 mg/dl
- sd LDL: <21 mg/dl
- Triglycerides: 40-160 mg/dl
- Lp(a): <30 mg/dl
- APO B: <60 mg/dl
- APO A-I: >130 mg/dl
- Homocysteine: <11 umol/L
- C-Reactive Protein: <5 mg/L
- High Sensitivity CRP: <1.0 mg/L
Total cholesterol is an aggregate of all types of cholesterol in your bloodstream, including both good and bad types. Cholesterol shouldn’t be too high or too low. In fact, having extremely low cholesterol is actually indicative of severe liver disease.
High density lipoprotein (HDL) is the “good” cholesterol that acts as a scavenger molecule, preventing a buildup of plaque in the arteries. HDL removes excess cholesterol from cells and takes it to the liver for recycling or disposal.
Low density lipoprotein (LDL) is the “bad” cholesterol that collects in arterial walls and causes blockage or a reduction in blood flow. The total cholesterol to HDL ratio is also important.
A subset of LDL is the very low density lipoprotein (VLDL), is a particularly bad type of cholesterol in which higher amounts increase the risk of heart disease.
Recent evidence suggests that small dense low-density lipoprotein (sd-LDL) particles tend to promote more formation of fatty plaques in the arteries than large-LDL in spite of their lower cholesterol content. In light of this evidence, this test may be a better indicator of heart disease risk than LDL.
Triglycerides are simply a form of fat that exists in the bloodstream. They’re transported by two other culprits, VLDL and LDL. A high triglycerides level is one of the risk factors for heart disease. Triglycerides levels can be increased if food or alcohol is consumed 12 to 24 hours prior to the blood draw, which is why you’re asked to fast for 12-14 hours from food and abstain from alcohol for 24 hours.
The Lp(a) test is used to identify an elevated level of lipoprotein (a) as a possible risk factor in the development of heart disease, independent of other lipid markers. The test may be used in conjunction with a routine lipid profile to provide additional information about a person’s risk for heart disease.
The dreaded Lp(a) is genetically determined and remains relatively constant over an individual’s lifetime. Since it is usually not affected by lifestyle changes or by most drugs, it is not the target of therapy. Instead, when Lp(a) is high, the presence of this added risk factor may suggest the need for more aggressive treatment of other, more treatable risk factors such as an elevated LDL.
Apo B is a protein that is involved in the metabolism of lipids and is the main protein constituent of lipoproteins such as LDL and VLDL. Elevated levels of Apo B correspond to an increased risk of cardiovascular disease, due to a high-fat diet and/or decreased clearance of LDL from the blood. Some genetic disorders are the direct (primary) cause of abnormal levels of Apo B with elevated cholesterol and triglycerides.
Apo A-I is a protein that has a specific role in the metabolism of lipids and is the main protein component in HDL. Levels of Apo A-I tend to rise and fall with HDL levels, and deficiencies in Apo A-I correlate with an increased risk of developing heart disease. An Apo A-I may be ordered along with an Apo B) test to determine an Apo B/Apo A-I ratio. This ratio is sometimes used as an alternative to a total cholesterol/HDL ratio (sometimes reported as part of a lipid profile) to evaluate risk for developing heart disease.
Unfortunately, this test isn’t always ordered by the doctor. It should be. Homocysteine is formed in the metabolism of the dietary amino acid methionine. The problem is that it’s a strong risk factor for atherosclerosis. In other words, high levels may cause you to have a heart attack. A good number of lifters should be concerned with this value as homocysteine levels rise with anabolic steroid usage.
Luckily, taking folic acid (about 400-800 mcg) as well as taking a good amount of all B vitamins in general will go a long way in terms of preventing a rise in levels of homocysteine.
CRP is used mainly as a marker of inflammation. Apart from liver failure, there are few known factors that interfere with CRP production. Recent research suggests that patients with elevated basal levels of CRP are at an increased risk of diabetes, high blood pressure, and heart disease. The high sensitivity CRP test is a more sensitive, and thus a more accurate reflection of active inflammation than the Erythrocyte Sedimentation Rate (ESR), a non-specific test of inflammation.
These are various tests that examine a number of components of your blood and look for any abnormalities that could be indicative of serious diseases.
Lab Values for Adult Males:
- WBC: 4.0-10.5 th/ul
- RBC: 4.2-5.8 ml/ul
- Hemoglobin: 12.6-17.7 g/dl
- Hematocrit: 37-51 %
- MCV: 80-100 fL
- MCH: 27-33 pg
- MCHC: 32-36 g/dl
- RDW: 11-15%
- Platelets: 140-415
- Absolute Neutrophils: 1.4-7.0 th/ul
- Absolute Lymphocytes: 0.7-4.5 th/ul
- Absolute Monocytes: 0.1-0.9 th/ul
- Absolute Eosinophils: 0.0-0.4 th/ul
- Absolute Basophils: 0.0-0.2 th/ul
- WBC Differential Count
Also referred to as leukocytes, a fluctuation in the number of these types of cells can be an indicator of things like infections and disease states dealing with immunity, cancer, stress, etc.
These blood cells also called erythrocytes and their primary function is to carry oxygen (via hemoglobin contained in each RBC) to various tissues. It gives our blood that cool “red” color. Unlike WBC, RBC survive in peripheral blood circulation for approximately 120 days. A decrease in the number of these cells can result in anemia which could stem from dietary insufficiencies. An increase in number can occur when androgens are used. This is because androgens increase EPO (erythropoietin) production, which in turn increases RBC count and thus elevates blood volume. Anyhow, the danger in this could be an increase in blood pressure or a stroke. This danger can be mitigated either by lowering androgens dosage or by donating blood.
Hemoglobin, found in each red blood cell, serves as a carrier for both oxygen and carbon dioxide transportation. An increase in hemoglobin can be an indicator of congenital heart disease, congestive heart failure, severe burns, or dehydration. Being at high altitudes, or the use of androgens, can cause an increase as well. A decrease in number can be a sign of anemia, lymphoma, kidney disease, sever hemorrhage, cancer, sickle cell anemia, etc.
Hematocrit is used to measure the percentage of the total blood volume that’s made up of red blood cells. An increase in percentage may be indicative of congenital heart disease, dehydration, diarrhea, burns, etc. A decrease in levels may be indicative of anemia, hyperthyroidism, cirrhosis, hemorrhage, leukemia, rheumatoid arthritis, pregnancy, malnutrition, etc.
This is one of three red blood cell indices used to check for abnormalities. The MCV is the size or volume of the average red blood cell. A decrease in MCV would then indicate that the red blood cells are abnormally large (or macrocytic), and this may be an indicator of iron deficiency anemia or thalassemia. An increase in MCV indicate abnormally small RBC (microcytic), and this may be indicative of a vitamin B12 or folic acid deficiency as well as liver disease.
The MCH is the weight of hemoglobin present in the average red blood cell. This is yet another way to assess whether some sort of anemia or deficiency is present.
The MCHC is the measurement of the amount of hemoglobin present in the average red blood cell as compared to its size. A decrease in number is an indicator of iron deficiency, thalassemia, lead poisoning, etc. An increase is sometimes seen after androgen use.
The RDW is an indicator of the variation in red blood cell size. It is used in order to help classify certain types of anemia, and to see if some of the red blood cells need their suits tailored. An increase in RDW can be indicative of iron deficiency anemia, vitamin B12 or folate deficiency anemia, and diseases like sickle cell anemia.
Platelets or thrombocytes are essential for your body’s ability to form blood clots and thus stop bleeding. They’re measured in order to assess the likelihood of certain disorders or diseases. An increase can be indicative of a malignant disorder, rheumatoid arthritis, iron deficiency anemia, etc. A decrease can be indicative of much more, including things like infection, various types of anemia, leukemia, etc.
The differential count measures the percentage of each type of leukocyte or white blood cell present in the same specimen. Using this, they can determine whether there’s a bacterial or parasitic infection, as well as immune reactions, etc. There are five different types of WBCs: neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
This is one type of white blood cell that’s in circulation for only a very short time. Essentially their job is phagocytosis, a process of killing and digesting bacteria that cause infection. Both severe trauma and bacterial infections, as well as inflammatory or metabolic disorders and even stress, can cause an increase in the number of these cells. Having a low number of neutrophils can be indicative of a viral infection, a bacterial infection, or a rotten diet.
Severe trauma and bacterial infections, as well as inflammatory disorders, metabolic disorders, and even stress can cause an increase in the number of these cells. Also, on the other side of the spectrum, a low number of these cells can indicate a viral infection, a bacterial infection, or a deficient diet.
Lymphocytes are a form of small leukocyte (white blood cell) with a single round nucleus, occurring especially in the lymphatic system. Lymphocytes can be divided into two different types of cells: T cells and B cells. T cells are involved in immune reactions and B cells are involved in antibody production. The main job of lymphocytes in general is to fight off bacterial and viral infections.
Many disorders can decrease the number of lymphocytes in the blood, but AIDS and undernutrition are the most common. People may have no symptoms, or they may have fever and other symptoms of an infection. Common causes of increased lymphocytes include viral and bacterial infections, such as mononucleosis, influenza or whooping cough (pertussis). A marked increase in lymphocytes may indicate a more serious condition, such as chronic lymphocytic leukemia.
Monocytes are similar to neutrophils but are produced more rapidly and stay in the system for a longer period of time.
These cells, and in particular, eosinophils, are present in the event of an allergic reaction as well as when a parasite is present. These types of cells don’t increase in response to viral or bacterial infections so if an increased count is noted, it can be deduced that either an allergic response has occurred or a parasite has taken up residence your body.
This panel is used by doctors to monitor your liver and kidney function as well as your electrolyte levels.
Lab Values for Adult Males:
- Glucose: 65-99 mg/dl
- BUN: 6-20 mg/dl
- Creatinine: 0.79-1.33 mg/dl
- BUN/Creatinine Ratio: 6-25
- Sodium: 135-146 mmol/L
- Potassium: 3.5-5.3 mmol/L
- Chloride: 98-110 mmol/L
- Carbon Dioxide: 21-33 mmol/L
- Calcium: 8.6-10.2 mg/dl
- Total Protein: 6.4-8.3 g/dl
- Albumin: 3.6-5.1 g/dl
- Globulin: 2.1-3.7 g/dl
- A/G Ratio: 1.0-2.0
- Bilirubin: 0.0-1.2 mg/dl
- Alkaline Phosphatase: 40-120 U/L
- AST: 10-40 U/L
- ALT: 9-60 U/L
The amount of glucose in the blood after a prolonged period of fasting (12-14 hours) is used to determine whether a person is in a hypoglycemic (low blood glucose) or hyperglycemic (high blood glucose) state. Both can be indicators of serious conditions. Increased levels can be indicative of diabetes mellitus, acute stress, Cushing’s syndrome, chronic renal failure, corticosteroid therapy, acromegaly, etc. Decreased levels could be indicative of hypothyroidism, insulinoma, liver disease, insulin overdose, and starvation.
This test measures the amount of urea nitrogen that’s present in the blood. When protein is metabolized, the end product is urea which is formed in the liver and excreted from the bloodstream via the kidneys. This is why BUN is a good indicator of both liver and kidney function. Increased levels can stem from shock, burns, dehydration, congestive heart failure, myocardial infarction, excessive protein ingestion, excessive protein catabolism, starvation, sepsis, renal disease, renal failure, etc. Causes of a decrease in levels can be liver failure, overhydration, negative nitrogen balance via malnutrition, etc.
Creatinine is a byproduct of creatine phosphate, the chemical used in contraction of skeletal muscle. So, the more muscle mass you have, the higher the creatinine levels and therefore the higher the levels of creatinine. Also, when you ingest large amounts of beef or other meats that have high levels of creatine in them, you can increase creatinine levels as well. Since creatinine levels are used to measure the functioning of the kidneys, this easily explains why creatine has been accused of causing kidney damage, since it naturally results in an increase in creatinine levels.
However, we need to remember that these tests are only indicators of functioning and thus outside drugs and supplements can influence them and give false results, as creatine may do. This is why creatine, while increasing creatinine levels, does not cause renal damage or impair function. Generally speaking, though, increased levels are indicative of urinary tract obstruction, acute tubular necrosis, reduced renal blood flow (stemming from shock, dehydration, congestive heart failure, atherosclerosis), as well as acromegaly. Decreased levels can be indicative of debilitation, and decreased muscle mass via disease or some other cause.
A high ratio may be found in states of shock, volume depletion, hypotension, dehydration, gastrointestinal bleeding, and in some cases, a catabolic state. A low ratio can be indicative of a low protein diet, malnutrition, pregnancy, severe liver disease, ketosis, etc. Keep in mind, though, that the term BUN, when used in the same sentence as hamburger or hotdog, usually means something else entirely. An important thing to note again is that with a high protein diet, you’ll likely have a higher ratio and this is nothing to worry about.
This cation (an ion with a positive charge) is mainly found in extracellular spaces and is responsible for maintaining a balance of water in the body. When sodium in the blood rises, the kidneys will conserve water and when the sodium concentration is low, the kidneys conserve sodium and excrete water. Increased levels can result from excessive dietary intake, Cushing’s syndrome, excessive sweating, burns, forgetting to drink for a week, etc. Decreased levels can result from a deficient diet, Addison’s disease, diarrhea, vomiting, chronic renal insufficiency, excessive water intake, congestive heart failure, etc. Anabolic steroids will lead to an increased level of sodium as well.
On the other side of the spectrum, you have the most important intracellular cation. Increased levels can be an indicator of excessive dietary intake, acute renal failure, aldosterone-inhibiting diuretics, a crushing injury to tissues, infection, acidosis, dehydration, etc. Decreased levels can be indicative of a deficient dietary intake, burns, diarrhea or vomiting, diuretics, Cushing’s syndrome, licorice consumption, insulin use, cystic fibrosis, trauma, surgery, etc.
This is the major extracellular anion (an ion carrying a negative charge). Its purpose it is to maintain electrical neutrality with sodium. It also serves as a buffer in order to maintain the pH balance of the blood. Chloride typically accompanies sodium and thus the causes for change are essentially the same.
The CO2 content is used to evaluate the pH of the blood as well as aid in evaluation of electrolyte levels. Increased levels can be indicative of severe diarrhea, starvation, vomiting, emphysema, metabolic alkalosis, etc. Increased levels could also mean that you’re a plant. Decreased levels can be indicative of kidney failure, metabolic acidosis, shock, and starvation.
Calcium is measured in order to assess the function of the parathyroid and calcium metabolism. Increased levels can stem from hyperparathyroidism, metastatic tumor to the bone, prolonged immobilization, lymphoma, hyperthyroidism, acromegaly, etc. It’s also important to note that anabolic steroids can also increase calcium levels. Decreased levels can stem from renal failure, rickets, vitamin D deficiency, malabsorption, pancreatitis, and alkalosis.
This measures the total level of both albumin and globulin in the body. Measuring the levels of these two proteins is also an indicator of nutritional status. As another important side note, anabolic steroids, growth hormone, and insulin can all increase protein levels.
Albumin is synthesized by the liver and as such is used as an indicator of liver function. It functions to transport hormones, enzymes, drugs and other constituents of the blood. Increased albumin levels can result from dehydration, while decreased albumin levels can result from malnutrition, pregnancy, liver disease, overhydration, inflammatory diseases, etc.
Globulins are the building blocks of your body’s antibodies. Increased globulin levels can result from inflammatory diseases, hypercholesterolemia (high cholesterol), iron deficiency anemia, as well as infections. Decreased globulin levels can result from hyperthyroidism, liver dysfunction, malnutrition, and immune deficiencies or disorders.
Some laboratories report total protein, albumin, and the calculated ratio of albumin to globulins, termed the A/G ratio. Normally, there is a little more albumin than globulins, giving a normal A/G ratio of slightly over 1. Because disease states affect the relative amounts of albumin and globulin, the A/G ratio may provide a clue as to the cause of the change in protein levels.
A low A/G ratio may reflect overproduction of globulins, such as seen in multiple myeloma or autoimmune diseases, or underproduction of albumin, such as may occur with cirrhosis, or selective loss of albumin from the circulation, as may occur with kidney disease (nephrotic syndrome).
A high A/G ratio suggests underproduction of immunoglobulins as may be seen in some genetic deficiencies and in some leukemias. More specific tests, such as liver enzyme tests and serum protein electrophoresis, must be performed to make an accurate diagnosis.
Bilirubin is one of the many constituents of bile, which is formed in the liver. An increase in levels of bilirubin can be indicative of liver stress or damage/inflammation. Drugs that may increase bilirubin include oral anabolic steroids, antibiotics, diuretics, morphine, codeine, contraceptives, etc. Drugs that may decrease levels are barbiturates and caffeine. Non-drug induced increased levels can be indicative of gallstones, extensive liver metastasis, and cholestasis from certain drugs, hepatitis, sepsis, sickle cell anemia, cirrhosis, etc.
This enzyme is found in very high concentrations in the liver and for this reason is used as an indicator of liver stress or damage. Increased levels can stem from cirrhosis, liver tumor, pregnancy, healing fracture, normal bones of growing children, and rheumatoid arthritis. Decreased levels can stem from hypothyroidism, malnutrition, pernicious anemia, scurvy (vitamin C deficiency) and excess vitamin B ingestion. As a side note, antibiotics can cause an increase in the enzyme levels.
Previously known as SGOT
This is another enzyme that’s used to determine if there’s damage or stress to the liver. When the liver is damaged or inflamed, AST levels can rise to a very high level (20 times the normal value). This happens because AST is released when the cells of that particular organ (liver) are lysed. The AST then enters blood circulation and an elevation can be seen. Increased levels can be indicative of heart disease, liver disease, skeletal muscle disease or injuries, as well as heat stroke. Decreased levels can be indicative of acute kidney disease, beriberi, diabetic ketoacidosis, pregnancy, and renal dialysis.
Previously known as SGPT
This is yet another enzyme that is found in high levels within the liver. Injury or disease of the liver will result in an increase in levels of ALT. However, because lesser quantities are found in skeletal muscle, there could be a weight-training induced increase. Weight training causes damage to muscle tissue and thus could slightly elevate these levels, giving a false indicator for liver disease. Still, for the most part, it’s a rather accurate diagnostic tool. Increased levels can be indicative of hepatitis, hepatic necrosis, cirrhosis, cholestasis, hepatic tumor, hepatotoxic drugs, and jaundice, as well as severe burns, trauma to striated muscle (via weight training), myocardial infarction, mononucleosis, and shock.
An iron panel is performed on adult males to check for hemochromatosis, or iron overload. Common symptoms include fatigue, joint pain, upper right abdominal pain, impotence, and loss of sex drive. While symptoms generally occur in men between ages 30-50. The disorder can be controlled by removing a pint of blood several times each year, which helps reduce iron to normal levels.
If an immediate relative is known to have hemochromatosis, strongly consider taking the test to determine if you inherited one or both of the common gene mutations. Additionally, consider testing if you are a Caucasian male of Northern European descent and are experiencing one or more of the symptoms noted above.
That’s because hemochromatosis is less prevalent in other ethnic groups, and men are more likely than women to have the disorder. Early detection and treatment can help you avoid serious medical complications.
Lab Values for Adult Males:
- Ferritin: 30-400 ng/ml
- TIBC: 250-450 ug/dl
- UIBC: 150-375 ug/dl
- Iron, serum: 40-155 ug/dl
- Iron saturation: 15-55 %
- Hemoglobin A1c: <5.7 %
- Folate: >3.0 ng/mL
- Vitamin B12: 200-1100 pg/ml
- Vitamin D25-Hydroxy: 30-100 ng/ml
Ferritin is the storage iron, or iron stored by the body and is not currently circulating. Ferritin levels correlate with and are useful in evaluation of total body storage iron. In hemochromatosis, both ferritin and iron saturation are increased. Ferritin levels in hemochromatosis may be >1000 ng/mL. Inflammation also increases ferritin, while decreasing serum iron.
TIBC or UIBC is most frequently used along with a serum iron test to evaluate people suspected of having either iron deficiency or iron overload. These two tests are used to calculate the iron saturation, a more useful indicator of iron status than just iron or TIBC alone. In healthy people, about 20-40% of available transferrin sites are used to transport iron.
In iron deficiency, the iron level is low but the TIBC is increased, thus transferrin saturation becomes very low. In iron overload states, such as hemochromatosis, the iron level will be high and the TIBC will be low or normal, causing the transferrin saturation to increase.
Serum iron is the circulating iron in your bloodstream. Low serum iron levels is indicative of malabsorption of iron through food, inflammation, hypothyroidism, or autoimmune disorders, and may be a precursor to anemia.
In an iron deficiency, the iron level is low but the TIBC is increased, thus iron saturation becomes very low. In iron overload states, such as hemochromatosis, the iron level will be high and the TIBC will be low or normal, causing the transferrin saturation to increase.
TIBC and/or UIBC may be ordered along with serum iron when it appears that a person has iron deficiency or overload. One or more tests may be ordered when there are signs of anemia, especially when a CBC is performed and shows red blood cells that are microcytic and hypochromic and the hemoglobin and hematocrit levels are low. The most common symptoms of anemia include: chronic fatigue/tiredness, dizziness, weakness, headaches, or pale skin (pallor).
When a doctor suspects that a person may have iron overload or when a person has a family history of hemochromatosis, iron and TIBC may be ordered along with a ferritin test. Symptoms of iron overload will vary from person to person and tend to worsen over time. They are due to iron accumulation in the blood and tissues. Symptoms may include: joint pain, fatigue, weakness, weight loss, lack of energy, abdominal pain, loss of sex drive, loss of hair, heart problems.
Hemoglobin A1c provides an average of your blood sugar control over the past 2 to 3 months and is used along with home blood sugar monitoring to make adjustments in your diabetes medicines.
For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes.
Vitamin B12 and folate are separate tests often used in conjunction to detect deficiencies and to help diagnose the cause of certain anemias, such as pernicious anemia, an autoimmune disease that affects the absorption of B12.
B12 and folate are two vitamins that cannot be produced in the body and must be supplied by the diet. They are required for normal red blood cell (RBC) formation, repair of tissues and cells, and synthesis of DNA, the genetic material in cells. B12 is essential for proper nerve function.
Vitamin D is a fat-soluble vitamin and is absorbed from the intestine like a fat. A vitamin D test is used to determine if bone weakness, bone malformation, or abnormal metabolism of calcium is occurring as a result of a deficiency or excess of vitamin D.
A low blood level of vitamin D may mean that a person is not getting enough exposure to sunlight, or enough dietary vitamin D to meet his or her body’s demand. There may also be a problem with its absorption from the intestines. There is some evidence that vitamin D deficiency may increase the risk of some cancers, immune diseases, and cardiovascular disease. A high level of vitamin D usually reflects excess supplementation from vitamin pills or other nutritional supplements.