Opinion: Your Laboratory Tests And What They Mean

A lot of people can read the annual report of the financial health of a company. I could make a good argument that you should also be able to read your laboratory reports which report on the health of your body, just as important to you, or more so, than the health of your investments.

There are more and more laboratory tests to help doctors with your diagnosis. These laboratory tests automatically flag results that are outside the “normal range” of healthy people. There’s also a profusion of information on the Internet available these days, some of which discuss specific abnormalities of these laboratory results. People move and change doctors a lot, and the information transfer from one Dr. to another may be imperfect. For these reasons it would seem reasonable for all people except for the most confirmed technophobes to keep track of their laboratory tests.

Ask for duplicates from the doctor, and keep them in a special  3-ring binder. A side benefit of doing this is to let the doctor know that you are an Informed consumer. She may well take more time with you.

I will go over the different common laboratory tables and discuss things that you should look for, starting with the hemogram, or blood count.

  • White blood cell count— White blood cells have diverse function, usually fighting infection. The total count is often elevated with bacterial  infection and diminished with viral infection. Out of range values are flagged.
  • Red blood cell count- Red blood cells carry oxygen to your tissues, and are diminished in anemia.
  • Hemoglobin and hematocrit- The hemoglobin is the vital oxygen carrying protein. The hematocrit measures the volume of the packed red  cells. Both measure the same thing as the red cell count, but in a different way.

Comment: about a half dozen years ago, I became more and more short of breath when walking my usual exercise routine. Eventually, I could only walk about a third of the distance, and ordered some lab work. I came back very anemic, with a hemoglobin of 8.5, far below the normal range.

Iron deficiency anemia is the most common kind, and so I ordered a ferritin level, which measures iron stores. It also was very low. I started myself on oral iron, and consulted a hematologist/oncologist who takes care of blood problems, and he had me continue on the same program. I had to take two of the standard Feosol tablets, each containing 200 mg of ferrous sulfate, and 65 mg of elemental iron. After several months, my hemoglobin came back up to its normal range over about 15g/dl, and the ferritin up to 63ng/ml.

I had a endoscopy of my colon, esophagus and stomach. Nothing was found, and the presumption is a small intestinal blood leak, taking blood and iron out of my body faster than a normal diet could replace it.

  • The MCV, MCH, MCHC, and or RDW are measures of red cells that are of concern to doctors, but which are not commonly important.
  • Platelet count- platelets are essential for normal blood clotting. They are usually not a problem unless you are on chemotherapy, which reduces platelets.

The different types of white cells—neutrophils, lymphocytes, monocytes, eosinophils, Basophils, and nucleated RBC are specific types of cells important in certain special conditions. Neutrophils are commonly elevated with bacterial infection, and reduced with viral infection.

When I was going to medical school, we did our own blood cell counts manually, by looking through a microscope at the blood cells on a special slide. Now there are amazing machines that do it much more rapidly and presumably accurately.

The blood count, or hemogram is important if you are sick, and it is a good idea to know your normal values when well, which then presumably are within the normal ranges printed on the laboratory report. Each laboratory uses a little different machinery, and therefore has its different normal ranges.

Next time I will talk about the urinalysis.

—Dr. C.

Ear Health: Diagnosing And Managing ‘Tinnitus’

Mayo Clinic – About 1 in 5 people experience the perception of noise or ringing in the ears. It’s called tinnitus. Dr. Gayla Poling says tinnitus can be perceived a myriad of ways. Hearing loss can be age-related, come from a one-time exposure, or exposure to loud sounds over a lifetime.

Dr. Poling says the tiny hairs in our inner ear may play a role. Dr. Poling says there’s no scientifically proven cure for tinnitus, but there are treatment and management options. Other options include using a sound generator or using a fan at night. If ringing in your ears bothers you, start by seeing your health care provider for a hearing test.

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Prostate Cancer: A PSMA Scan Predicts Recurrence

“We found that the information we could get from PSMA scanning in patients with newly-diagnosed prostate cancer before surgery was at least as reliable and useful as other information from biopsy, PSA levels, or clinical exam for predicting how patients would do after surgery or other treatment,” says Farshad Moradi, a radiologist at Stanford who co-authored the study.

In December, scientists at Stanford University reported promising findings with a new technology that lights up prostate tumors on specialized imaging scans. The approach relies on a minimally-radioactive tracer that travels the body hunting for cancer cells.

Called 68Ga-PSMA-11, and delivered intravenously, the tracer binds exclusively with a protein called prostate- specific membrane antigen (PSMA). Prostate cancer cells contain far more of this protein on their surfaces than normal prostate cells do. Tumors flagged by 68Ga-PSMA-11 show up on an imaging scan like lit matches in a dark room. Doctors are already using PSMA scans to diagnose early metastatic cancer, and the tracer can also be used to ferry drugs directly into malignant tumors.

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EPIGENETICS & AGING: DNA BREAKAGE & REPAIR EFFECTS

Harvard Medical School – A 13-year international study in mice demonstrates that loss of epigenetic information, which influences how DNA is organized and regulated, can drive aging independently of changes to the genetic code itself.

It also shows that restoring the integrity of the epigenome reverses age-related symptoms.

Learn more at https://hms.harvard.edu/news/loss-epi…

INFOGRAPHIC: OBESITY AND CARDIOVASCULAR DISEASE

Our new position paper with @worldheartfed summarises the relationship between obesity and cardiovascular disease (#CVD) mortality.

World Obesity Federation (January 2023) – The ongoing obesity epidemic represents a global public health crisis that contributes to poor health outcomes, reduced quality of life, and >2.8 million deaths each year. Obesity is relapsing, progressive, and heterogeneous. It is considered a chronic disease by the World Obesity Federation (WOF) and a chronic condition by the World Heart Federation (WHF).

People living with overweight/obesity are at greater risk for cardiovascular (CV) morbidity and mortality. Increased adiposity (body fat), particularly visceral/abdominal fat, is linked to CV risk and CV disease (CVD) via multiple direct and indirect pathophysiological mechanisms. The development of CVD is driven, in part, by obesity-related metabolic, endocrinologic, immunologic, structural, humoral, haemodynamic, and functional alterations.

Learn more: http://bit.ly/3THvOZa

Cardiology: When Chest Discomfort Is Serious

Mayo Clinic – Chest discomfort and pain account for more than 6.5 million emergency department visits in the U.S. each year. Discomfort can be the first sign of a serious heart event or a symptom of other medical conditions. Dr. Regis Fernandes, a Mayo Clinic cardiologist, says people should seek medical care at the first sign of chest pain.

Reviews: The Lancet On Top Five Health Priorities

The Lancet (January 2023) – For our 200th anniversary year we have identified five Spotlight subjects of particular importance. Watch as Richard Horton, Editor-in-Chief, and other Lancet Editors around the world outline these Spotlights and discuss priorities for the future of health.

The Lancet Infectious Diseases | Journal | ScienceDirect.com by Elsevier

This year, we draw attention to the most critical issues impacting health globally, the extraordinary people involved in tackling them, and the voices of those most impacted. For five Spotlights, we will run a programme of activities to bring these issues to life and convene the right people and resources in order to drive change in these areas.

Spotlight on Universal Health Coverage
Ensuring all populations globally have access to affordable, quality health care

Spotlight on Research for Health
Prioritising evidence to guide and inform decision making

Spotlight on Child and Adolescent Health
Prioritising the health needs of children and adolescents now

Spotlight on Health and Climate Change
Tackling climate change through the lens of human health

Spotlight on Mental Health
Implementing sustainable global mental health in a fragmenting world

Empowering Patients Through Education And Telemedicine