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.