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Before we proceed, what are the Four Ominous Signs in Blood work?
Four Ominous Signs of Blood Work
- Albumin 3.5 or below with a 1500 or less lymphocyte count
- Calcium levels higher than 2.7
- A/G ratio less than 1.0
- Cholesterol values below 140
Lab Results Interpretation
Through this guide, we will help you interpret your results from the lab which often includes CBC, LFT, KFT, INR, and more. Hope it helps you understand the importance of individual reports.
GLUCOSE
Glucose is the chief source of energy for all living organisms. A level greater than 105 in someone who has fasted for 12 hours suggests a diabetic tendency.
If this level is elevated even in a non-fasting setting one must be concerned that there is a risk of developing diabetes. This is an incredibly powerful test and can predict diabetes for ten years or more before one develops the strict definition of diabetes which is levels greater than 120.
- Clinical Adult Range: 70-115 mg/dL
- Optimal Adult Range: 85-100 mg/dL
- Red Flag Range <50 or >250 mg/dL
Common Causes of Glucose Increase
Diabetes, poor carbohydrate utilization, syndrome X
Less Common Causes of Glucose Increase
Cerebral lesions, uremia, pregnancy, intracranial pressure, Cushing’s disease, hyperthyroidism, chronic nephritis, infections, first 24 hours after a severe burn, pancreatitis, cerebral lesions, uremia, early hypopituitarism.
Common Causes of Glucose Decrease
Fasting Hypoglycemia
Clinical Note: LDH will frequently be decreased or in the low normal with Fasting Hypoglycemia, however, LDH will almost ALWAYS be decreased with Reactive Hypoglycemia.
Less Common Causes of Glucose Decrease
Liver damage, pancreatic adenoma, Addison’s disease (adrenal insufficiency), starvation, late hypopituitarism Carcinoma of islet tissue
Clinical Notes: Order Glycohemoglobin (HGB A1C) with serum glucose values above 160 and to monitor diabetics under therapy
Nutrition Tip: Thiamine Deficiency has been linked to increases in glucose levels.
SODIUM
Sodium 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 low level can also be caused by loss of sodium in diarrhea, fluid, or vomiting. A high level can be caused by too much intake of salt or by not enough intake of water.
- Clinical Adult Range: 135-145 mmol/L
- Optimal Adult Range: 140-144 mmol/L
- Red Flag Range <125 or >155 mmol/L
Common Causes of Sodium Increase
Nephritis (kidney problems), dehydration, hyper-cortico-adrenalism (increased adrenal function)
Clinical Notes: Water Softeners have been linked to causing an increase in sodium.
Common Causes of Sodium Decrease
Reduced kidney filtration, diarrhea, Addison’s disease, adrenal hypo-function
POTASSIUM
Potassium element is found primarily inside the cells of the body. Low levels in the blood may indicate severe diarrhea, alcoholism, or excessive use of water pills. Low potassium levels can cause muscle weakness and heart problems.
- Clinical Adult Range: 3.5-5.0 mmol/L
- Optimal Adult Range: 4.0-4.6 mmol/L
- Red Flag Range <3.0 or >6.0 mmol/L
Common Causes of Potassium Increase
Adrenal hypo-function, cortisol resistance, acidosis, ongoing tissue destruction
Common Causes of Potassium Decrease
Diarrhea, diuretic use, kidney problems, adrenal hyperfunction
Less Common Causes of Potassium Decrease
Anemia, overdosage of testosterone, hereditary periodic paralysis, and hypertension
Nutrition Tip: Excessive licorice consumption has been linked to lower potassium levels.
MAGNESIUM
Magnesium is an important element that is found in the arteries, heart, bone, muscles, nerves, and teeth.
- Clinical Adult Range: 1.7-2.4 mg/dL
- Optimal Adult Range: 2.2-2.6 mg/dL
- Red Flag Range <1.2 mg/dL
Common Causes of Magnesium Increase
Kidney problems
Common Symptoms of Magnesium Deficiency
Anxiety, aching muscles, disorientation, low body temperature, easily angered, hyperactivity, insomnia, muscle tremors, nervousness, rapid pulse, sensitivity to noise and loud sounds, epilepsy
Clinical Note: Magnesium should be evaluated in all patients suffering from heart disease.
Clinical Note: Patient suffering from fibromyalgia may have low serum magnesium accompanied by a low C02 and an increased anion gap.
Nutrition Tip: Excessive use of antacids containing magnesium may increase magnesium levels.
Clinical Note: If your magnesium is less than 2.0, it is strongly recommended to have an erythrocyte magnesium test or a magnesium loading test.
CHLORIDE
Chloride is an electrolyte controlled by the kidneys and can sometimes be affected by diet. An electrolyte is involved in maintaining acid-base balance and helps to regulate blood volume and artery pressure.
Elevated levels are related to acidosis as well as too much water crossing the cell membrane.
- Clinical Adult Range: 96-110 mmol/L
- Optimal Adult Range: 100-106 mmol/L
- Red Flag Range <90 or >115 mmol/L
Common Causes of Chloride Increase
Renal (kidney) problems, metabolic acidosis
Common Causes of Chloride Decrease
Kidney problems, metabolic alkalosis, hypochlorhydria (too little acid in the stomach)
Less Common Causes of Chloride Increase
Hyperventilation, anemia, prostate problems, salicylate poisoning, excess intake of salt, dehydration
Less Common Causes of Chloride Decrease
Diabetes, pneumonia, intestinal obstruction, and pyloric spasm. Adrenal hypo-function
Clinical Note: Suspect hypochlorhydria if chloride is below 100, the total globulin is less than 2.4 and serum phosphorus is less than 3.0.
Clinical Note: Chloride is required for the production of HCL by the chief cells of the stomach.
BLOOD UREA NITROGEN
Blood Urea Nitrogen or BUN is a waste product derived from protein breakdown in the liver.
Increases can be caused by excessive protein intake, kidney damage, certain drugs, low fluid intake, intestinal bleeding, exercise, heart failure, or decreased digestive enzyme production by the pancreas.
Decreased levels are most commonly due to inadequate protein intake, malabsorption, or liver damage.
- Clinical Adult Range: 10-26 mg/dL
- Optimal Adult Range: 13-18 mg/dL
- Red Flag Range <5 or >50 mg/dL
Common Causes of BUN Increase
Renal disease, gout, drug diuretics
Common Causes of BUN Decrease
Pregnancy, protein malnutrition
Less Common Causes of BUN Increase
Metallic poisoning, pneumonia, ulcers, Addison’s disease, increased protein catabolism, dysbiosis, congestive heart failure
Less Common Causes of BUN Decrease
Acute liver destruction, dysbiosis, celiac sprue
Clinical Note: Decreased BUN of less than 8 with a decreased urinary specific gravity may indicate posterior pituitary dysfunction.
Clinical Note: Increased BUN above 25 usually indicates kidney disease. However, if Creatinine is not above 1.1, then kidney disease may not be the problem. Instead consider anterior pituitary dysfunction, dehydration or hypochlorhydria.
Nutrition Tip: Increased BUN may indicate a Boron deficiency.
CREATININE
Creatinine is also a protein breakdown product. Its level is a reflection of the body’s muscle mass.
Low levels are commonly seen in inadequate protein intake, liver disease, kidney damage, or pregnancy.
Elevated levels are generally reflective of kidney damage and need to be monitored very carefully.
- Clinical Adult Range: 0.7-1.5 mg/dL
- Optimal Adult Range: 0.7-1.0 mg/dL
- Red Flag Range >1.6 mg/dL
Common Causes of Creatinine Increase
Kidney Problems, Gout
Clinical Note: If Creatinine is 1.2 or higher in a male over the age of 40, Prostate Hypertrophy MUST be ruled out.
Less Common Causes of Creatinine Increase
Renal Hypertension, uncontrolled diabetes, congestive heart failure, urinary tract infection, dehydration
Clinical Note: Suspect early nephritis ( kidney disease) if creatinine is between 2-4 mg/dL. Suspect severe nephritis is creatinine is between 4-35 mg/dL.
Common Causes of Creatinine Decrease
Amyotonia congenital
BUN/CREATININE RATIO
Increased values of the BUN/Creatinine Ratio may indicate catabolic states, dehydration, circulatory failure leading to declining renal blood flow, congestive heart failure, acute and chronic renal (kidney) failure, urinary tract obstruction, prostatic enlargement, and high protein diet.
Decreased values may indicate overhydration, low protein/high carbohydrate diet, pregnancy
- Clinical Adult Range: 6-10
- Optimal Adult Range: 10-16
- Red Flag Range <5 or >30
Common Causes of BUN/Creatinine Ratio Increase
Kidney problems
Less Common Causes of BUN/Creatinine Ratio Increase
Catabolic states, prostatic hypertrophy, high protein diet, dehydration, shock
Common Causes of BUN/Creatinine Ratio Decrease
Low protein/high carbohydrate diet, pregnancy
URIC ACID
Uric acid is the end product of purine metabolism. High levels are seen in gout, infections, high protein diets, and kidney disease. Low levels generally indicate protein and molybdenum (trace mineral) deficiency, liver damage, or an overly acidic kidney.
- Clinical Female Range: 2.4-6.0 mg/dL
- Clinical Male Range: 3.4-7.0 mg/dL
- Optimal Female Range: 3.0-5.5 mg/dL
- Optimal Male Adult Range: 3.5-5.9 mg/dL
- Red Flag Range <2 mg/dL or >9.0 mg/dL
Common Causes of Uric Acid Increase
Gout, kidney problems, arteriosclerosis, arthritis
Less Common Causes of Uric Acid Increase
Metallic poisoning (mercury, lead), intestinal obstruction, leukemia, polycythemia, malignant tumors, drug diuretics
Common Causes of Uric Acid Decrease
Chronic B-12 or folate anemia, pregnancy
Less Common Causes of Uric Acid Increase
Salicylate and atropine therapy
Nutrition Tip: If the uric acid is low with a normal MCV and MCH, a molybdenum deficiency may be present.
PHOSPHORUS
Phosphorus is closely associated with calcium in bone development. Therefore most of the phosphate in the body is found in the bones. But the phosphorus level in the blood is very important for muscle and nerve function.
Very low levels of phosphorus in the blood can be associated with starvation or malnutrition and this can lead to muscle weakness. High levels in the blood are usually associated with kidney disease.
However, the blood must be drawn carefully as improper handling may falsely increase the reading.
- Clinical Adult Range: 2.5-4.5 mg/dL
- Optimal Adult Range: 3.2-3.9 mg/dL
- Red Flag Range <2.0 mg/dL or >5.0 mg/dL
Common Causes of Phosphorus Increase
Parathyroid dysfunction, kidney dysfunction, and excessive phosphoric acid in soft drinks.
Important Fact: Children will have an increase in Phosphorus due to normal bone growth. In addition, people with fractures will usually reveal an increase.
Less Common Causes of Phosphorus Increase:
Bone tumors, edema, ovarian hyper-function, diabetes, excess intake of vitamin D
Common Causes of Phosphorus Decrease
Parathyroid Hyper-function, osteomalacia, rickets
Less Common Causes of Phosphorus Decrease
Diabetes, liver dysfunction, protein malnutrition, neurofibromatosis, myxedema
Nutrition Tip: Phosphorus is frequently decreased with diets high in refined sugars.
Clinical Note: Suspect Vitamin D deficiency with low levels of calcium, phosphorus and increased levels of alkaline phosphorus.
Clinical Note: Phosphorus is a general indicator of digestive function. Consider hypochlorhydria when phosphorus is below 3.0 and total serum globulin is greater than 3.0 or less than 2.4.
CALCIUM
Calcium is the most abundant mineral in the body. It is involved in bone metabolism, protein absorption, fat transfer, muscular contraction, the transmission of nerve impulses, blood clotting, and heart function.
It is highly sensitive to elements such as magnesium, iron, and phosphorous as well as hormonal activity, vitamin D levels, CO2 levels, and many drugs.
Diet or even the presence of calcium in the diet has a lot to do with “calcium balance” – how much calcium you take in and how much you lose from your body.
- Clinical Adult Range: 8.5-10.8 mg/dL
- Optimal Adult Range: 9.7-10.1 mg/dL
- Red Flag Range <7.0 mg/dL or >12.0 mg/dL
Common Causes of Calcium Increase
Hyperparathyroidism
Less Common Causes of Calcium Increase
Tumors of the thyroid, hypervitaminosis (excess Vitamin D), multiple myeloma, neurofibromatosis, osteoporosis, ovarian hypo-function, adrenal hypo-function
Clinical Note: Serum protein influences calcium levels. Calcium goes up with increased protein and goes down with decreased protein.
Common Causes of Calcium Decrease
Hypoparathyroidism, pregnancy, hypochlorhydria, kidney dysfunction
Less Common Causes of Calcium Decrease
Vitamin D deficiency, diarrhea, celiac disease, protein malnutrition, chemical/heavy metal toxicity, HPA-axis dysfunction
Clinical Fact: Poor intestinal fat absorption may be suspected with low levels of calcium, bilirubin, and phosphorus.
Nutrition Note: Pancreatic enzyme deficiency may be suspected with low levels of calcium, triglycerides and increased levels of LDH.
Clinical Note: Circadian rhythm abnormality should be a primary consideration with calcium levels either above or below normal.
ALBUMIN
Albumin is the most abundant protein in the blood, it is made in the liver and is an antioxidant that protects your tissues from free radicals. It binds waste products, toxins, and dangerous drugs that might damage the body.
It also is a significant buffer in the body and plays a role in controlling the precise amount of water in our tissues. It serves to transport vitamins, minerals, and hormones.
Lower levels are seen in poor diets, diarrhea, fever, infections, liver disease, kidney disease, third-degree burns, edemas, or hypocalcemia.
- Clinical Adult Range: 3.0-5.5 g/dL
- Optimal Adult Range: 4.0-4.4 g/dL
- Red Flag Range <4.0 g/dL
Common Causes of Albumin Increase
Dehydration
Less Common Causes of Albumin Increase
Thyroid and adrenal hypo-function
Common Causes of Albumin Decrease
Liver Disease
Less Common Causes of Albumin Decrease
Acute Nephritis, malnutrition, acute cholecystitis (gall bladder), multiple sclerosis, vitamin B-12 or folic acid anemia
Clinical Note: Albumin 3.5 or below with a 1500 or less lymphocyte count is one of the four OMINOUS signs.
Nutrition Tip: Decreased albumin with decreased serum phosphorus may indicate digestive inflammation.
Calcium/Albumin Ratio
It is elevated in malnutrition or visceral protein loss. Levels higher than 2.7 is one of the four OMINOUS signs.
GLOBULIN
Globulins have many diverse functions such as the carrier of some hormones, lipids, metals, and antibodies.
High levels are found in chronic infections, liver disease, rheumatoid arthritis, myelomas, and lupus.
Lower levels may be seen in immune-compromised patients, with poor dietary habits, malabsorption, and liver and kidney disease.
- Clinical Adult Range: 2.0-4.0 g/dL
- Optimal Adult Range: 2.8-3.5 g/dL
- Red Flag Range <2.0 g/dL or >3.5 g/100ml
Common Causes of Globulin Increase
Hypochlorhydria, liver disease (infection)
Less Common Causes of Globulin Increase
Liver parasites, multiple myeloma, rheumatoid arthritis, typhoid fever
Common Causes of Globulin Decrease
Anemia, hemorrhage
Clinical Note: Anytime the total globulin is less than 2.0 or greater than 3.5 a Serum Protein Electrophoresis.
A/G RATIO
A/G Ratio is an important indicator of disease states. A low ratio suggests ulcerative colitis, burns, kidney disease, cirrhosis, and multiple myeloma.
A/G ratio less than 1.0 is one of the four OMINOUS signs.
- Clinical Adult Range: 1.1-2.5
- Optimal Adult Range:1.2-1.5
- Red Flag Range <1.0
Nutrition Note: Elevated A/G ratio, elevated protein, and elevated cholesterol may indicate too high protein consumption.
ALKALINE PHOSPHATASE
ALP or Alkaline phosphatase is an enzyme that is found in all body tissue, but the most important sites are bone, liver, bile ducts, and the 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 do.
Low levels indicate low-functioning adrenal glands, protein deficiency, malnutrition, or more commonly, a deficiency in zinc.
- Clinical Adult Range: 30-115 U/L
- Optimal Adult Range: 60-80 U/L
- Red Flag Range <30 U/L or >Laboratory range
Common Causes of Alkaline Phosphatase Increase
A primary bone lesion, invasive liver lesion, biliary duct (liver) obstruction, osteomalacia, Paget’s disease, rheumatoid arthritis
Less Common Causes of Alkaline Phosphatase Increase
Excess ingestion of Vitamin D, rickets, Cirrhosis of the liver, adrenal hyper-function, shingles, Hodgkin’s disease, osteogenic sarcoma, alcoholism, multiple myeloma, jaundice
Common Causes of Alkaline Phosphatase Decrease
Anemia, Hypothyroidism, celiac disease
Less Common Causes of Alkaline Phosphatase Decrease
Adrenal hypo-function, vitamin C deficiency, progesterone deficiency
Nutrition Note: Alkaline Phosphatase levels below 70 U/L may indicate a Zinc Deficiency.
Clinical Note: Any patient having a significant increase in Alkaline Phosphatase should have an ALP isoenzyme.
Clinical Note: It is considered “NORMAL” for Alkaline Phosphatase to be elevated in children under 18 and people with bone fractures.
SGPT/ALT & SGOT/AST
Transaminases (SGPT/ALT) & (SGOT/AST) are enzymes that are primarily found in the liver.
Drinking too much alcohol, certain drugs, liver disease and bile duct disease can cause high levels in the blood. Hepatitis is another problem that can raise these levels.
Low levels of GGT may indicate a magnesium deficiency. Low levels of SGPT and SGOT may indicate a deficiency of vitamin B6.
- Clinical Adult Range: 0-41 U/L
- Optimal Adult Range: 18-26 U/L
- Red Flag Range >100 U/L
SGOT/AST is found in the heart, skeletal muscles, brain, liver, and kidneys.
Clinical Note: In acute congestive heart failure and/or myocardial infarction, the SGOT/AST will significantly increase. However, these values will slowly return to normal. SGPT/ALT will also increase in these cardiac heart emergencies, however, SGOT/AST normally will not return to normal as quickly as SGPT.
Common Causes of SGOT/AST Increase
Myocardial Infarction, pulmonary embolism, congestive heart failure, myocarditis
Other Common Causes of SGOT/AST Increase
Hepatitis, liver cirrhosis, liver disease, pancreatitis
Less Common Causes of SGOT/AST Increase
Liver neoplasm
Nutrition Note: Low levels of SGOT/AST and SGPT/ALT may indicate a B-6 deficiency.
Common Causes of SGPT/ALT Increase
Acute hepatitis, cirrhosis of the liver, mononucleosis
Less Common Causes of SGPT/ALT Increase
Pancreatitis, biliary dysfunction, diabetes
Clinical Note: SGPT values are greater than SGOT in liver obstruction, and toxic hepatitis. SGOT values are greater than SGPT in cirrhosis of the liver, liver neoplasms and jaundice.
GGT (Gamma-Glutamyl transerase)
Gamma-Glutamyl Transferase (GGT) is believed to be involved in the transport of amino acids into cells as well as glutathione metabolism. Found in the liver and will rise with alcohol use, liver disease, or excess magnesium.
- Clinical Adult Range: 0-55 U/L
- Optimal Adult Range: 10-30 U/L
- Red Flag Range >90 U/L
Common Causes of GGT Increase
Biliary obstruction, alcoholism, cholangitis/cholecystitis (bile duct and gall bladder inflammation)
Clinical Note: If GGT is greater than 150 U/L with a serum bilirubin of over 2.8 mg/dL, strongly suspect a biliary obstruction. Seek immediate medical attention.
Clinical Note: If GGT values are five times higher than the clinical range suspect pancreatitis.
Less Common Causes of GGT Increase
Brucellosis, hepatitis, mononucleosis, bacterial and viral infection, malignancy, congestive heart failure biliary.
Nutrition Note: Low levels of GGT may indicate a B-6 deficiency.
Additional Clinical Notes: Food allergy/sensitivity is a very common finding with biliary dysfunction.
LDH
Lactate Dehydrogenase or LDH is an enzyme found in all tissues of the body.
A high level in the blood can result from a number of different diseases such as hepatitis, anemia, etc.
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.
- Clinical Adult Range: 60-225 U/L
- Optimal Adult Range: 140-200 U/L
- Red Flag Range >250 U/L
Common Causes of LDH Increase
Liver/biliary dysfunction, pulmonary embolism, myocardial infarction, tissue inflammation, tissue destruction, malignancy anywhere in the body, several types of anemias
Clinical Note: LDH will frequently increase with low thyroid function.
Clinical Note: LDH is frequently increased with birth control usage.
Nutrition Note: Decreased LDH may indicate reactive hypoglycemia (check glucose).
TOTAL PROTEIN
Total Protein: This is a measure of the total amount of protein in your blood. The total protein is the combination of albumin and total globulin and is affected by albumin and total globulin.
A low or high total protein does not indicate a specific disease, but it does indicate that some additional tests may be required to determine if there is a problem.
- Clinical Adult Range: 6.0-8.5 g/dL
- Optimal Adult Range: 7.1-7.6 g/dL
- Red Flag Range <5.9 g/dL or > 8.5 g/dL
Common Causes of Protein Increase
Dehydration, “early” carcinoma, and multiple myeloma (should be correlated with serum protein electrophoresis).
Less Common Causes of Protein Increase
Malignancy, diabetes, rheumatoid arthritis
Common Causes of Protein Decrease
Protein malnutrition, digestive inflammation (colitis, gastritis)
Less Common Causes of Protein Decrease
Hypothyroidism, leukemia, adrenal hyper-function, congestive heart failure
Nutrition Note: If protein and calcium are found to be on the low side of the Optimal range suspect poor protein absorption.
Additional Nutrition Notes: Decreased protein, cholesterol, and SGPT may indicate fatty liver congestion.
IRON
The body must have iron to make hemoglobin and to help transfer oxygen to the muscle.
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.
If this test is low you should consider getting a Ferritin test, especially if you are a female who still has menstrual cycles.
- Clinical Adult Range: 40-150 ug/ml
- Optimal Adult Range: 50-100 ug/ml
- Red Flag Range <25 ug/ml or >200 ug/ml
Common Causes of Iron Increase
Hemochromatosis, liver dysfunction, iron therapy, pernicious and hemolytic anemia
Less Common Causes of Iron Increase
Cooking with iron utensils
Common Causes of Iron Decrease
Pathologic bleeding (especially in the geriatric population), iron deficiency anemia
Less Common Causes of Protein Decrease
Chronic infections, kidney and liver problems
Nutrition Note: Increased iron with decreased hematocrit (HCT) suggests intrinsic factor deficiency.
Clinical Notes: An iron evaluation is not complete without ordering Ferritin (see below).
FERRITIN
The Ferritin test is considered the “gold standard” in documenting iron deficiency anemia.
Low levels below 25 indicate a need for iron. In contrast, high levels may an inflammatory disorder, infections, rheumatoid arthritis, and chronic kidney disease.
- Clinical Male Adult Range: 33-236 ng/mL
- Clinical Female Adult Range (before menopause): 11-122 ng/mL
- Clinical Female Adult Range (after menopause): 12-263 ng/mL
- Optimal Male Adult Range: 20-200 ng/mL
- Optimal Female Adult Range (before menopause): 10-110 ng/mL
- Optimal Female Adult Range(after menopause): 20-200 ng/mL
- Red Flag Range <8 ng/mL or >500 ng/mL
Common Causes of Ferritin Increase
Iron overload, hemochromatosis
Less Common Causes of Ferritin Increase
Inflammation, liver disease, rheumatoid arthritis
Common Causes of Ferritin Decrease
Iron deficiency anemia
Less Common Causes of Ferritin Decrease
Free radical pathology
Clinical Notes: If serum ferritin is greater than 1000, suspect hemochromatosis.
Clinical Notes: Iron overload and/or hemochromatosis are silent and can result in cirrhosis of the liver, bacterial infections, dementia, arteriosclerosis, diabetes, and stroke.
Nutrition Note: Doctors specializing in chelation have found a correlation between increased iron and arteriosclerosis.
TRIGLYCERIDES
Triglycerides are fats used as fuel by the body, and as an energy source for metabolism.
Increased levels are almost always a sign of too much carbohydrate intake and hyperlipidism. On the other hand, decreased levels are seen in hyperthyroidism, malnutrition, and malabsorption.
- Clinical Adult Range: 50-150 mg/dL
- Optimal Adult Range: 70-110 mg/dL
- Red Flag Range <35 mg/dL or >350 mg/dL
Common Causes of Triglycerides Increase
Hyperlipidism, diabetes, alcoholism
Less Common Causes of Triglycerides Increase
Hypothyroidism, early stages of fatty liver
Common Causes of Triglycerides Decrease
Chemical/heavy metal overload, liver dysfunction, hyperthyroid function
Clinical Notes: Resistive exercise training has been found to be effective in lowering elevated triglycerides.
CHOLESTEROL
Cholesterol is a group of fats vital to cell membranes, nerve fibers, and bile salts, and a necessary precursor for the sex hormones.
High levels indicate a diet high in carbohydrates/sugars.
Low levels indicate a low-fat diet, malabsorption, anemia, liver disorders, and carbohydrate sensitivity.
Cholesterol values below 140 are considered one of the four OMINOUS signs.
- Clinical Adult Range: 120-200 mg/dL
- Optimal Adult Range: 150-180 mg/dL
- Red Flag Range <50 mg/dL or >400 mg/dL
Common Causes of Cholesterol Increase
Early stages of diabetes, fatty liver, arteriosclerosis, hypothyroidism
Less Common Causes of Cholesterol Increase
Biliary obstruction, multiple sclerosis, pregnancy
Common Causes of Cholesterol Decrease
Liver dysfunction, chemical/heavy metal overload, hyperthyroidism, viral hepatitis, free radical pathology
Nutrition Note: Increased cholesterol levels have been found to be lowered by the amino acid methionine.
Clinical Notes: A cholesterol level below 130 is considered one of Four Ominous signs.
Clinical Notes: If cholesterol is above 220 with an SGPT below 10 suspect liver congestion/fatty liver
LDL CHOLESTEROL
LDL is the cholesterol-rich remnants of the lipid transport vehicle VLDL (very-low-density lipoproteins) there have been many studies to correlate the association between high levels of LDL and arterial arteriosclerosis.
- Clinical Adult Range: <130 mg/dL
- Optimal Adult Range: <120 mg/dL
- Red Flag Range >180 mg/dL
Common Causes of Cholesterol LDL Increase
Arteriosclerosis, diabetes, Syndrome X
Nutrition Note: Increased cholesterol levels have been found to be lowered by the amino acid methionine
HDL
HDL or High-density lipoprotein is the cholesterol carried by the alpha lipoproteins.
A high level of HDL is an indication of a healthy metabolic system if there is no sign of liver disease or intoxication.
The two mechanisms that explain how HDL offers protection against chronic heart disease are that HDL inhibits cellular uptake of LDL and serves as a carrier that removes cholesterol from the peripheral tissues and transports it back to the liver for catabolism.
- Clinical Adult Males Range: >50 mg/dL
- Clinical Adult Female Range: >55 mg/dL
- Optimal Adult Male Range: >55 mg/dL
- Optimal Adult Male Range: >60 mg/dL
- Red Flag Range <35 mg/dL
Common Causes of HDL Cholesterol Decrease
Arteriosclerosis, diabetes, Syndrome X
Less Common Causes of HDL Cholesterol Decrease
Cigarette smoking, steroids, beta-blockers
Nutrition Note: Diets high in refined carbohydrates, lack of exercise, and genetic predisposition have been found to lower HDL.
Clinical Notes: If HDL is decreased, triglycerides are greater than 50% of the cholesterol value, LDL is increased and uric acid is increased rule out arteriosclerosis.
CHOLESTEROL/HDL RATIO
The Cholesterol/HDL ratio is an important marker of cardiovascular health. A ratio of <4.0 is considered adequate. A ratio of <3.1 is ideal.
Carbon Dioxide (CO2)
The CO2 level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the body’s buffering system.
Generally, when used with the other electrolytes, carbon dioxide levels indicate pH or acid/alkaline balance in the tissues. This is one of the most important tests that we measure.
Most people have too much acid in their bodies. If you garden you will know that it is very difficult to grow plants in the soil where the pH is incorrect.
Our blood is similar to soil in many respects and it will be difficult to be healthy if our body’s pH is not well balanced. An ABG helps understand the results better.
- Clinical Adult Range: 24-32 mmol/L
- Optimal Adult Range: 26-30 mmol/L
- Red Flag Range <18 mmol/L or >38 mmol/L
Common Causes of CO2 Increase
Alkalosis, hypochlorhydria
Less Common Causes of CO2 Increase
Acute vomiting, fever, adrenal hyper-function, emphysema (respiratory distress)
Common Causes of CO2 Decrease
Acidosis
Less Common Causes of CO2 Decrease
Diabetes, sleep apnea, severe diarrhea
Nutrition Note: Low levels of CO2 may indicate a need for thiamine (a B vitamin).
Clinical Notes: If CO2 is above 32mmol/L, a Pulmonary Function Test should is warranted.
WHITE BLOOD CELLS
WBC or White blood count measures the total number of white blood cells in a given volume of blood. Since WBCs kill bacteria, this count is a measure of the body’s response to infection.
- Clinical Adult Range: 4,500-11,000 cubic mm
- Optimal Adult Range: 5,000-8,000 cubic mm
- Red Flag Range <3,000 cubic mm or >13,000 cubic mm
Common Causes of WBC Increase
Active Infections, Leukemia, Childhood diseases (measles, mumps, chicken-pox, rubella, etc.
Less Common Causes of WBC Increase
Asthma, emphysema, adrenal dysfunction, intestinal parasites, severe emotional stress
Common Causes of WBC Decrease
Chronic Viral or Bacterial Infections, Lupus (SLE)
Less Common Causes of WBC Decrease
Hepatitis, Immune dysfunction, Chemical/Heavy metal toxicity
Nutrition Note: Decreased WBC may indicate a need for Vitamin B-12, B-6, and folic acid.
Clinical Notes: An increase or decrease in total WBC in conjunction with a lymphocyte count below 20 and serum albumin below 4.0 is a pattern frequently seen in a developing neoplasm (tumor).
NEUTROPHILS
Neutrophils are typically elevated in acute infection.
- Clinical Adult Range: 35-65 percent of total WBC
- Optimal Adult Range: 40-60 percent of total WBC
- Red Flag Range <30 percent of total WBC or >80 percent of total WBC
Common Causes of Neutrophils Increase
See WBC
Common Causes of WBC Decrease
See WBC
Clinical Notes: Neutrophils tend to increase with chronic bacterial infections and decrease with chronic viral infections.
MONOCYTES
Monocytes are elevated in bacterial infections and protozoal infections.
- Clinical Adult Range: 0-10 percent of total WBC
- Optimal Adult Range: <7 percent of total WBC
- Red Flag Range >15 percent of total WBC
Common Causes of Monocytes Increase
Bacterial Infections, parasitic infections
Common Causes of WBC Decrease
High doses of corticosteroids will depress monocytes
Clinical Notes: Increased monocytes are frequently present with prostate hypertrophy, and ovarian and uterine dysfunction.
Clinical Notes: An increase in monocytes with an increase in the basophils (>1.0) and a mild increase of eosinophils (>3.0) may indicate intestinal parasites.
LYMPHOCYTES
Lymphocytes are elevated in acute and chronic infections. Decreased in viral infection and immune deficiency.
- Clinical Adult Range: 20-40 percent of total WBC
- Optimal Adult Range: 25-40 percent of total WBC
- Red Flag Range <20 percent of total WBC or >55 percent of total WBC
Common Causes of Lymphocytes Increase
Chronic viral or bacterial infection, Childhood diseases (measles, mumps, chicken-pox, rubella, etc.), HIV, Hepatitis
Less Common Causes of Lymphocytes Increase
Chemical/heavy metal toxicity
Common Causes of Lymphocytes Decrease
Active infections
Clinical Notes: Suspect viral infections when the lymphocytes increase to a point that either equals or exceeds the neutrophil level.
EOSINOPHILS
Eosinophils are elevated in allergic conditions, skin diseases, and parasitic diseases.
- Clinical Adult Range: 0-7 percent of total WBC
- Optimal Adult Range: 0-3 percent of total WBC
- Red Flag Range <20 percent of total WBC or >55 percent of total WBC
Common Causes of Eosinophils Increase
Allergic condition (asthma), food sensitivities, parasitic infection
Less Common Causes of Eosinophils Increase
Chemical/heavy metal toxicity, Hodgkin’s disease, ovarian and bone tumors
BASOPHILS
Basophils are elevated in Infections.
- Clinical Adult Range: 0-2 percent of total WBC
- Optimal Adult Range: 0-1 percent of total WBC
- Red Flag Range <5 percent of total WBC
Common Causes of Basophils Increase
Inflammation, Childhood diseases (measles, mumps, chicken-pox, rubella, etc.), acute trauma, and parasites
Less Common Causes of Basophils Increase
Chemical/heavy metal toxicity
Clinical Notes: Symptoms of inflammation in the absence of trauma may indicate a need to order C-Reactive Protein and/or a Sed rate.
Clinical Notes: Consider ordering a comprehensive stool and digestive test to rule out intestinal parasites if the basophils are increased with no sign of inflammation.
RED BLOOD CELLS
RBCs (Red Blood Cells) are made in the spleen. Reveals the oxygen-carrying ability of the blood.
- Clinical Adult Male Range: 4.60-6.0 million cu/mm
- Clinical Adult Female Range: 3.90-5.50 million cu/mm
- Optimal Adult Male Range: 4.20-4.90 million cu/mm
- Optimal Adult Female Range: 3.90-4.50 million cu/mm
- Red Flag Range for Men <3.90 or >6.00 million cu/mm
- Red Flag Range for Women <3.50 or >5.00 million cu/mm
Common Causes of RBC Increase
Polycythemia, dehydration, Respiratory Distress (asthma, emphysema)
Less Common Causes of RBC Increase
Acute poisoning, cystic fibrosis, adrenal hyperfunction
Common Causes of RBC Decrease
Iron deficiency anemia, internal bleeding
Less Common Causes of RBC Decrease
Excessive exercise, salicylate toxicity, lead poisoning
Nutrition Tip: Low levels of RBC may indicate a need for B-12, B-6, and folic acid.
Clinical Notes: Consider checking iron and ferritin levels with low levels of RBC.
HEMOGLOBIN
Hemoglobin: Hemoglobin provides the main transport of oxygen and carbon in the blood. It is composed of “globin”, a group of amino acids that form a protein, and “heme”, which contains iron.
It is an important determinant of anemia (decreased hemoglobin) or poor diet/nutrition or malabsorption.
- Clinical Adult Male Range: 13.5-18.0 g/dL
- Clinical Adult Female Range: 12.5-16.0 g/dL
- Optimal Adult Male Range: 14.0-15.0 g/dL
- Optimal Adult Female Range: 13.5-14.5 g/dL
- Red Flag Range <10.0 or >17 g/dL
Common Causes of Hemoglobin Increase
Polycythemia, dehydration, emphysema, asthma
Common Causes of Hemoglobin Decrease
Anemia, internal bleeding, digestive inflammation
Nutrition Tip: Low levels of Hemoglobin may indicate a need for B-12, folic acid, and thiamine.
Clinical Notes: Consider checking iron and ferritin levels with low levels of Hemoglobin.
HEMATOCRIT
Hematocrit is the measurement of the percentage of red blood cells in whole blood. It is an important determinant of anemia (decreased), dehydration (elevated), or possible overhydration (decreased).
- Clinical Adult Male Range: 40.0-52.0 percent
- Clinical Adult Female Range: 36.0-47.0 percent
- Optimal Adult Male Range: 40.0-48.0 percent
- Optimal Adult Female Range: 37.0-44.0 percent
- Red Flag Range <32.0 or >55 percent
Common Causes of Hematocrit Increase
Same as hemoglobin
Common Causes of Hematocrit Decrease
Same as hemoglobin
Clinical Notes: Suspect Iron anemia if serum iron, hemoglobin, and hematocrit are all low.
Clinical Notes: Suspect B-6 anemia if MCT, hematocrit, and iron are low (also look for a low SGOT).
Clinical Notes: Suspect B12/folic acid anemia if you have a low hematocrit with a high MCH, MCV, and iron.
Clinical Notes: Consider getting a ferritin test.
PLATELETS
Platelets are concerned with the clotting of the blood.
- Clinical Adult Range: 150,000-450,000 cubic mm
- Optimal Adult Range: 200,000-300,000 cubic mm
- Red Flag Range <50,000 or >600,000 cubic mm
Common Causes of Platelets Increase
Polycythemia, inflammatory arthritis, several types of anemia, arteriosclerosis, and acute blood loss
Common Causes of Platelets Decrease
Leukemia, liver dysfunction
Less Common Causes of Platelets Decrease
Chemical/heavy metal toxicity
Nutrition Tip: Low levels of Platelets may indicate a B12, folic, selenium, and iron deficiency.
Clinical Notes: The following drugs have been found to lower Platelets: quinidine, heparin, gold salts, sulfas, digitoxin.
RETICULOCYTE COUNT
Reticulocyte Count is an excellent test to confirm chronic microscopic bleeding.
- Clinical Adult Range: 0.5-1.5%
- Optimal Adult Range: same as the clinical range
- Red Flag Range >2.0%
Common Causes of Reticulocyte Count Increase
Internal bleeding
Common Causes of Reticulocyte Count Decrease
Vitamin b-12, B-6 and folic acid anemia
MCV
Mean Corpuscular Volume (MCV) indicates the volume occupied by the average red blood cell.
- Clinical Adult Range: 81.0-99.0 cubic microns
- Optimal Adult Range: 82.0-89.9 cubic microns
- Red Flag Range <78.0 or >95.0 cubic microns
Common Causes of MCV Count Increase
Vitamin B-12/Folic Acid Anemia
Common Causes of MCV Count Decrease
Iron anemia, internal bleeding
Clinical Notes: If the MCV is >89.9 and the MCH is >31.9, suspect Vitamin B-12 or folic anemia. This should be confirmed with a serum or urinary methylmalonic (vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6).
Clinical Notes: If iron and ferritin are normal and MCV, MCH, Hemoglobin, and Hematocrit are all decreased, suspect a toxic metal body burden.
MCH
Mean Corpuscular Hemoglobin (MCH) indicates the volume occupied by the average red blood cell.
- Clinical Adult Range: 26.0-33.0 micrograms
- Optimal Adult Range: 27.0-31.9 micrograms
- Red Flag Range <24.0 or >34.0 micrograms
Common Causes of MCV Count Increase:
Vitamin B-12/Folic Acid Anemia
Common Causes of MCV Count Decrease
Iron anemia, internal bleeding
Clinical Notes: If the MCV is >89.9 and the MCH is >31.9, suspect Vitamin B-12 or folic anemia. This should be confirmed with a serum or urinary methylmalonic (vitamin B-12) and serum or urinary homocysteine (folic acid and vitamin B-6).
Clinical Notes: If iron and ferritin are normal and MCV, MCH, Hemoglobin, and Hematocrit are all decreased, suspect a toxic metal body burden
T3
T3 (Tri-Iodothyronine) is a thyroid hormone produced mainly from the peripheral conversion of thyroxine (T-4).
- Clinical Adult Range: 22-33%
- Optimal Adult Range: 26-30%
Common Causes of T3 Increase
Hyperthyroidism
Common Causes of T3 Decrease
Hypothyroidism
T4
T-4 (Tetra-Iodothyronine) is the major hormone secreted by the thyroid gland.
- Clinical Adult Range: 4.0-12.0 mcg/dL
- Optimal Adult Range: 7.0-8.5 mcg/dL
Common Causes of T4 Increase
Hyperthyroidism
Common Causes of T3 Decrease
Hypothyroidism, anterior pituitary hypo-function
T7
T7 (FTI-Free Thyroxine Index) is an estimate, calculated from T-4 and T-3 uptake.
- Clinical Adult Range: 4.0-12.0 mcg/dL
- Optimal Adult Range: 7.0-8.5 mcg/dL
Common Causes of T7 Increase
See T-3 uptake
Common Causes of T3 Decrease
See T-3 uptake
T-3 UPTAKE
T-3 Uptake measures the unsaturated binding sites on the thyroid binding proteins.
- Clinical Adult Range: 22-36%
- Optimal Adult Range: 27-37%
- Red Flag Range <20 percent of uptake or >39 percent of uptake
Common Causes of T-3 Uptake Increase
Thyroid hyperfunction
Less Common Causes of T-3 Uptake Increase
Kidney dysfunction, salicylates toxicity, and protein malnutrition
Common Causes of T3 Decrease
Thyroid hypo-function
TSH
TSH (Thyroid Stimulating Hormone) is used to confirm or rule out suspected hypothyroidism when T3, T4, and T7 are essentially normal and clinical signs suggest hypothyroidism.
- Clinical Adult Range: 0.4-4.4 mlU/L
- Optimal Adult Range: 2.0-4.0 mlU/L
- Red Flag Range <0.3 mlU/L or >10.0 mlU/L
Common Causes of TSH Increase
Thyroid hypofunction
Less Common Causes of TSH Increase
Liver dysfunction
Common Causes of TSH Decrease
Thyroid hyper-function, anterior hypo-function
Clinical Notes: The axillary temperature (underarm) will frequently be <97.8 with thyroid hypo-function. The axillary temperature should be taken for 10 minutes before leaving the bed and ideally should be taken for five days in a row and averaged. Reduced axillary temperature is common with adrenal stress, thiamine deficiency, diets low in essential fatty acids, and protein malnutrition.
Clinical Notes: Difficulty losing weight, fatigue, lack of motivation, sensitivity to cold, dry or scaly skin, ringing in ears, low blood pressure, impaired hearing, constipation, difficulty working under pressure, and headaches that start in the morning but improve during the day.
ESR (Erythrocyte Sedimentation Rate)
ESR (Erythrocyte Sedimentation Rate) documents if the organic disease is truly present in patients with vague symptoms. Monitors the course of chronic inflammatory conditions. Elevated in patients with a breakdown of tissue.
- Clinical Adult Male <50 Range: 0-15mm/hour
- Clinical Adult Male >50 Range: 0-20mm/hour
- Clinical Adult Male <50 Range: 0-25mm/hour
- Clinical Adult Female >50 Range: 0-30mm/hour
- Optimal Adult Male Range: <5mm/hour
- Optimal Adult Female Range: <10mm/hour
- Red Flag Range >45 mm/hour
Common Causes of ESR Increase
Tissue Inflammation
Bilirubin?