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Pathology/Blood Test Results

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QUESTION: HI Dr Neha!

I just received the results from my latest blood tests today and wondered if you can take a look and help me understand any issues that you might see? Please note the measurements are all in metric.

Chemistry (serum)

Sodium - 141 mmol/L ( Reference range - 135 - 145 )
Potassium - 4.7 mmol/L ( Reference range - 3.5 - 5.5 )
Chloride - 105 mmol/L ( Reference range - 135 - 145 )
Bicarbonate - 22 mmol/L ( Reference range - 20 - 32 )
Anion Gap - 14 mmol/L ( Reference range - 5 - 15 )

Ca (corr) - 2.41 mmol/L ( Reference range - 2.10 - 2.55 )
Phosphate - 1.1 mmol/L ( Reference range - 0.8 - 1.5 )

Urea - 5.5 mmol/L ( Reference range - 3.0 - 8.0 )
Urate - 0.37 mmol/L ( Reference range - 0.20 - 0.50 )
Creatinine - 72 umol/L ( Reference range - 60 - 110 )
eGFR - >90 ( Reference Range - >59 )

Fast Glucose - 5.6 mmol/L ( Reference range - 3.6 - 6.0 )

Total Protein - 77 g/L ( Reference Range - 66 - 83 )
Albumin - 47 gL ( Reference Range - 39 - 50 )
Globulin - 30 g/L ( Reference Range - 20 - 39 )
T Bilirubin - 10 umol/L ( Reference range - 4 - 20 )
ALP - 66 U/L ( Reference Range - 35 - 110 )
AST - 37 U/L ( Reference Range - 10 - 40 )
ALT - 53 U/L ( Reference Range - 5 - 40 )
GGT - 30 U/L ( Reference Range - 5 - 40 )
LDH - 186 U/L ( Reference Range - 120 - 250 )

Cholesterol - 7.4 mmol/L ( Reference range - 3.9 - 5.5 )
Triglyceride - 5.0 mmol/L ( Reference range - 0.6 - 2.0 )
HDL - 0.91 mmol/L ( Reference range - 0.90 - 1.50 )
Measured LDL - 3.7 mmol/L ( Reference range - 0. 0 - 4.0 )
Cholesterol/HDL Ratio - 8.1 ( Reference range - 0. 0 - 4.5 )

Comments on Lab - Suggested optimal treatment targets for patients are:
LDL Cholesterol - <2.0 mmol/L
HDL Cholesterol - >1.00 mmol/L
Triglycerides - <1.5 mmol/L

Androgens

Testosterone - 9.0 nmol/L ( Reference Range - 11.0 - 40.0 )

Anaemia Profile

Iron - 22 umol/L ( Reference Range - 5 - 30 )
Transferrin - 2.3 g/L ( Reference Range - 1.9 - 3.1 )
Haemolysis Index - 7 ( Reference Range - 0 - 40 )
TIBC - 57 umol/L ( Reference Range - 45 - 72 )
Trans Saturation - 39% ( Reference Range - 20 - 55 )
Ferritin - 287 ug/L ( Reference Range - 25 - 220 )

I am aware the cholesterol and triglycerides are an issue and I am working on these with my Doctor. I did have some concerns about Iron and Ferritin though.

Any thoughts or opinions will be gratefully received. Thanks!

ANSWER: Hello Steve:

I apologize for the delay in responding to your query.
Majority of the tests are within range. The lipid profile is abnormal with elevated cholesterol and  triglycerides. Dietary and lifestyle modifications will help. If not medication can be used.

Iron is within range with minimal elevation of Ferritin. Ferritin is a protein which contains iron. Elevated ferritin may indicate that your body is storing more iron.
It could also point to liver disease, rheumatoid arthritis, other inflammatory conditions or hyperthyroidism.

If you are otherwise healthy then this could even be a normal value for you as most of the values are averages of a set of population. So some people can fall outside this range.
Hope this helps

---------- FOLLOW-UP ----------

QUESTION: Hi Dr Neha,

Thank you for your response.

I was a little worried about my iron/ferritin levels as some people were saying it was high.

Is there anything in the lab work showing liver issues? I am healthy, but am concerned that I have non-alcoholic fatty liver. I don't drink.

Thanks,

Answer
Hello Again:

Your liver function tests are within normal range - Total protein,  albumin, globulin, bilirubin, ALP, AST, ALT, GGT and LDH.

ALT is the only enzyme minimally elevated at 53U/L. An isolated test being out of range is not necessarily indicative of liver damage/disease. Mild elevation can be due to damage to skeletal muscle or cardiac muscle. Vigorous exercise prior to getting the test done can also increase the levels of AST or ALT.

So nothing here is indicative of liver disease. An ultrasound exam of the liver will pick up very early changes of fatty liver.

Pathology

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Neha Dahiya MD

Expertise

Help patients understand the medical terminology of their lab results and / or tissue biopsy reports.

Experience

I am a pathologist and director of clinical laboratory services. I have been a practicing pathologist for last 9 years in a 350 bed multi specialty hospital laboratory in India.

Organizations
Indian association of pathologists and microbiologists.
International Academy of Cytology
International association of Pathologists - Indian division
Indian association of Cytology

Education/Credentials
MD (pathology) MBA

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