How to Understand Lab Values A Guide to Optimal Health
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How to Understand Lab Values: A Guide to Optimal Health
No part of this document may be reproduced in any form, including photocopying or transmission electronically to any computer, without the prior written consent of The Academy For Integrative Medicine (AIM). The information contained in this document is proprietary to AIM, and may not be used or disclosed except as expressly authorized in writing by AIM. AIM assumes no responsibility for errors or omissions that may appear in this publication. While all attempts have been made to verify information
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provided in this publication, neither the Authors nor the Publisher assume any responsibility for errors, inaccuracies, or omissions. Any slights of people or organizations are unintentional. Company names and product names mentioned in this document may be trademarks or registered trademarks of their respective companies and are hereby acknowledged. AIM reserves the right to change this publication at any time without notice. The content, forms, checklists, and strategies contained herein are for illustrative purposes only. This guide offers health, fitness, and nutritional information and is designed for educational purposes only. You should not rely on this information as a substitute for, nor does it replace, professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional. Do not disregard, avoid, or delay obtaining medical or health-related advice from your healthcare professional because of something you may have read in this guide. The use of any information provided in this guide is solely at your own risk. This information has not been evaluated by the FDA and is not intended to treat, diagnose, cure, or prevent any disease. This information is not intended as a substitute for the advice or medical care of a qualified healthcare professional and you should seek the advice of your healthcare professional before undertaking any dietary or lifestyle changes. The material provided herein is for educational purposes only. If you require actual medical care, you can schedule a one-on-one functional medicine consultation with me or another licensed healthcare practitioner or integrative medicine health coach for any specific health issues you may be experiencing.
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About the Author Dr. Keesha Ewers is board certified in functional medicine and Ayurvedic medicine, as well as being a doctor of sexology, psychotherapist, energy worker, yoga teacher, and founder and a host of the Healthy YOU! Radio network (www.healthyyouradio.com). After curing her own autoimmune disease and discovering the key to low libido in women through her innovative research, Dr. Keesha developed the Freedom Framework, designed to get to the root problem of any disease or imbalance. Dr. Ewers is the founder of a field of medicine called Functional Sexology. Through the Academy for Integrative Medicine, she offers a certification course for those passionate about becoming Integrative Medicine Health Coaches. Her online programs and videos can be found at www.DrKeesha.com. Dr. Keesha has discovered that many health problems can be successfully reversed using individualized nutritional plans, high quality nutritional supplementation, and tools for healing long-held stress triggers that make the body sustain the diseasecausing “fight or flight survival mode� of living.
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A note from Dr. Keesha Over the last 30+ years I have seen my patients confused and befuddled about what their laboratory results actually mean. They wonder why their doctor says they are healthy and fine when they still struggle with low libido, fatigue, moodiness, weight, memory, and sleep. This is why: There are functional medicine levels for labs and there are conventional medicine levels for labs. These are different. Functional and integrative medicine look at the root cause of imbalances and keep a closer eye on developing imbalances that lab levels indicate. Conventional medicine matches the drug with the symptom and the lab result. This means conventional medicine is looking for disease, while integrative medicine is looking to prevent disease. In other words, conventional medicine waits until the car has driven over the edge of the cliff and crashed in a fiery ball of flames before intervening. Integrative medicine starts to sound warning bells when you are getting too close to the edge of the cliff and helps you turn the car around before the crash. This guide is for you as a gift from me so you can turn your car around. Please do not go over the cliff. It’s much harder to set your health on a stable path when you are on fire. Love,
Dr. Keesha
P.S.: You will see supplement and supplement kit recommendations scattered throughout this guide. These are vetted by me for quality, economy, and efficacy. Many people get lost in knowing how to pick the right nutrients for their health issues.
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Table of Contents
Introduction.................................................................................7 Your Endocrine System...........................................................9 Your Immune System...............................................................19 Your Digestive System.............................................................28 Your Cardiovascular System..................................................31 Your Urinary System.................................................................35 Nutritional Information...........................................................38
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Introduction Has your doctor ever said your lab values were “normal” yet you didn’t feel well? This happens more than you might think, and there is a very good reason for it. Conventional lab values provided on lab reports are based on a “bell curve analysis” of all the people that have been to the lab over “x” amount of time (usually in the past year). Naturally, this includes a great number of sick people. In other words, “normal” ranges are stretched beyond what are truly healthy ranges. The sicker the population gets, the wider, and less useful the lab reference ranges become. In fact, because of this, if you go to the same lab in two different cities, you will find that the reference ranges differ. For this reason, it is imperative to have a provider who looks at “functional” or optimal ranges. This much more accurately indicates health or imbalance. You won’t be considered normal or healthy just because your lab results fall in the range of the majority of people that have been to that lab. In this short guide, we will look at functional ranges for the main lab tests currently in use. I have organized this guide around the various systems in the body. However, the body is not a series of boxes and many lab values will overlap in various systems. I have also made an attempt to keep this information simple and easy to understand. This guide is by no means an exhaustive encyclopedia of anatomy and physiology. It’s meant to help you determine if your levels are optimal so you can keep your car from driving off of the edge of the cliff. With that in mind,
LET’S GET STARTED!
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Your Endocrine System
Your Endocrine System The endocrine system is the collection of glands that produce hormones that regulate metabolism, growth and development, tissue function, sexual function, reproduction, sleep, and mood, among other things. The endocrine system is made up of the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries (in females) and testicles (in males). The word endocrine derives from the Greek words “endo,” meaning within, and “crinis,” meaning to secrete. In general, a gland selects and removes materials from the blood, processes them and secretes the finished chemical product for use somewhere in the body. The endocrine system affects almost every organ and cell in the body. I will touch on some of the more common lab values you will see associated with your endocrine system.
Your Adrenals Cortisol is a life-sustaining adrenal hormone that is released when you feel you are threatened. Cortisol is called “the stress hormone,” and has an influence on many of the body’s activities such as:
Hydration
Your immune system
Metabolism of protein, carbohydrates, and fat to maintain healthy blood sugar levels
Your blood pressure
Your central nervous system
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“Normal” cortisol levels fluctuate throughout the day and night in a circadian rhythm that peaks at about 8 AM and is at its lowest around 4 AM. Cortisol is meant to spike when you are threatened. However, it must return to normal circadian function or you will be at risk for adrenal fatigue and imbalances in the functions listed above. You are not meant to be in a constant state of “fight or flight,” which will happen with chronic perceived stress. This can lead to:
• Hypothyroidism • Poor memory
• Decrease in immune function
• Insomnia
• Increase in abdominal fat
• Blood sugar instability
• High cholesterol
• Osteopenia or osteoporosis
• Depression and anxiety
• High blood pressure (or low blood pressure)
• Fatigue • Inflammation
• Decrease in muscle tone and mass
I recommend salivary testing from a qualified functional medicine laboratory. The results of a saliva test will look something like these cortisol graphs. Which one matches your results?
WIRED BUT TIRED: Phase 1 Adrenal Fatigue
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MIXED UP: Phase 2 Adrenal Fatigue
CRASHED OUT: Phase 3 Adrenal Fatigue
These graphs are simple examples of a more complex endocrine system issue. It is important to work closely with an integrative medicine practitioner or health coach to assess your adrenals with an individualized approach that addresses your entire endocrine system. In the meantime, try this kit to see if you feel better:
ACCESS HERE
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Lab Value Cortisol-Morning Cortisol-Noon Cortisol-Afternoon Cortisol-Nighttime Cortisol Sum DHEA-S Average Cortisol/DHEA-S Ratio
Time
Optimal Range
6-8 AM 12-1 PM 4-5 PM 10 PM-12 AM
13.0-24.0 nM/L 5.0-8.0 nM/L 4.0-7.0 nM/L 1.0-3.0 nM/L 23.0-42.0 nM/L 2.00-10.00 ng/ml 5.0-6.0
If you want to learn to really understand all of these labs, you can become an integrative medicine health coach yourself! Check out the Academy For Integrative Medicine’s 6 month online training program!
Your Pituitary and Thyroid The pituitary gland is located in the brain. It releases thyroid stimulating hormone (TSH) to stimulate the thyroid gland to produce T4. T4 circulates in the body and converts to T3. T3 is the active hormone that is absorbed by the cells and tissues in the body. If your medical provider is only testing for TSH, they are only looking at the function of the brain and not the function of the thyroid. To understand the TSH range, you have to realize that the larger the TSH number, the more hypo-thyroid you are. The lower the TSH, the more hyper-thyroid you are. Your TSH fluctuates a lot, responding to your adrenal glands and your stress levels. One TSH value that is out of range is not a reason to start on medication. You must always treat yourself, not your labs. Do you have symptoms of hypothyroidism, and more importantly, do you have
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adrenal fatigue? Are you chronically tired, losing your hair, sleepless, cold, have no sex drive? These are symptoms of an endocrine imbalance, not just a thyroid imbalance. If you are already being medicated for hypothyroid or hyperthyroid, please work with your health team to adjust your medication to attain the functional medicine lab value range that reflects a well-controlled thyroid. Different labs use different reporting methods for their lab values. If your free T3 or free T4 results on your report are much different than the chart below, you likely have a different reporting system at your lab. You can convert them here.
Lab Value TSH Free T3 Free T4
Median
Minimum
Optimal Range
0.99 2.69 1.09
0.36 1.99 0.93
1.91 3.17 1.0
Free T3 and Free T4 are considered the most important labs to run because Free T3 is the hormone that is available to the cell to use. Most conventional providers do not test these labs. They look at TSH and Total T4 and Total T3 and that’s all. Most conventional providers also use only synthetic thyroid medications with the premise that they can treat in a one-size-fits-all approach. You are not a one-size-fits-all person. It is important to work closely with an integrative medicine practitioner to assess your thyroid with an individualized approach that addresses your entire endocrine system.
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In the meantime, you can get started using this kit, which contains the nutrients necessary for a healthy thyroid:
ACCESS HERE
If you have been diagnosed with a hypothyroidism condition, then you have a 90% chance that it was caused by an autoimmune condition called Hashimoto’s (named after the doctor who identified it). Sometimes the autoimmune markers will be negative, but that does NOT mean you aren’t autoimmune. Always ask to have Thyroid Peroxidase Antibody, Thyroglobulin Antibody, and Thyroid Stimulating Hormone Receptor Antibodies tested. You can reverse autoimmune thyroid issues. You will have to address a condition called leaky gut, that is always present with autoimmune disease. You will also need to look for food sensitivities, deal with your stress in a better way, and lead a healthy lifestyle. To learn more about how to do this, you can become an integrative medicine health coach yourself!
CHECK OUT THE
ACADEMY FOR INTEGRATIVE MEDICINE’S 6 MONTH ONLINE TRAINING PROGRAM!
Your Pancreas The pancreas is part of the endocrine system and plays a role in food digestion. One of the disorders of the pancreas that is often tested for is diabetes. There are 5 classifications of diabetes:
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Type 1 diabetes: An autoimmune chronic condition in which the pancreas produces little or no insulin.
Type 2 diabetes: A chronic condition that affects the way the body processes blood sugar (glucose).
Type 3 diabetes: A classification that has been proposed for Alzheimer’s disease, which results from resistance to insulin in the brain.
Gestational diabetes: A form of high blood sugar affecting pregnant women.
Pre-diabetes or Insulin Resistance: A condition in which blood sugar is high, but not high enough to be type 2 diabetes. Diabetes is not a blood sugar problem, it’s an insulin problem. High blood sugar is a symptom of insulin resistance or a lack of insulin production.
20%
Of type 2 diabetics are misdiagnosed and are actually suffering from Latent Autoimmune Diabetes in Adults (LADA).
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If you have LADA, you will likely not be overweight. You might even believe you are living a healthy lifestyle, but still are at risk for being on insulin as a result of pancreatic destruction. Insulin resistance is due to lifestyle choices such as physical inactivity, overeating, high sugar and high starch snacks and meals, and a lack of fiber. At this stage you might find yourself feeling tired after meals, craving sweets, and struggling to lose weight. One of the lab indicators for insulin resistance is an elevated triglycerides level. Therefore I test for: Triglycerides
Fasting blood sugar
Hgb A1c
keep the range less than 70
70-86
keep the range below 5.5
My favorite lab value to assess for a stable blood sugar is the Hgb A1c. The Hemoglobin A1c represents an ‘average’ of the blood sugar over a 90-120 day period. That means it’s a snapshot of the last 3 months of blood sugars. This makes it much more helpful than a fasting blood glucose taken once every year.
Your Sex Hormones Steroid hormones have a huge impact on many functions in the body. All of these hormones are inter- dependent rather than functioning in isolation; so a comprehensive evaluation is essential if you want to get to the root cause of any hormone imbalance.
Some of the common issues people struggle with that are influenced by imbalanced hormones are: • Amenorrhea
• Osteoporosis
• Galactorrhea
• Menstrual irregularities How to Understand Lab Values A Guide to Optimal Health
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• Infertility/Miscarriage
• Sexual dysfunction
• Cardiovascular Disease
• Hypo- or Hyperthyroidism
• Ovarian cysts
• Polycystic Ovarian Syndrome
• Breast Cancer
• Vaginal Dryness
• Uterine fibroids
• Fibrocystic Breast Disease
• Autoimmune Disease
• Incontinence
• Endometrial Cancer
Lab Value
Estradiol (salivary)
Female Optimal Follicular:
1.0-5.0 PG/ML
Mid-cycle:
3.0-8.0 PG/ML
Luteal:
1.0-5.0 PG/ML
Post-menopause:
00.5-3.0 PG/ML
Physiological
4.0-14.0 PG/ML
(on BHRT):
Estriol (salivary)
2-98 PG/ML
Estrone (salivary)
20-50 PG/ML
Progesterone (salivary)
Male Optimal
1.0-3.0 PG/ML
0.5-40 PG/ML
Pre-menopause
50-200 PG/ML
Post-menopause
05.0-95 PG/ML
Physiological (on BHRT):
100-500 PG/ML
5-100 PG/ML
Testosterone (salivary)
20-60 PG/ML
40-130 PG/ML
Melatonin (salivary)
12-35.0 PG/ML
12-35.0 PG/ML
*Sex Hormone Binding Globulin
18-114 nnmol/L
18-114 nnmol/L
Prostate Surface Antigen (PSA)
<4.0
*Sex hormone-binding globulin (SHBG) is a glycoprotein that binds to sex hormones, specifically testosterone and estradiol. SHBG inhibits the function of these hormones. Because the bioavailability of sex hormones is influenced by the level of SHBG, I always test for it. When struggling with a hormone imbalance, an easy first step is to supplement with the proper nutrients such as the high quality ones found in this kit:
ACCESS HERE
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Your Immune System
Your Immune System The immune system is the bodyâ&#x20AC;&#x2122;s defense against infectious organisms and other invaders. Through a series of steps called the immune response, the immune system attacks organisms and substances that invade body systems and cause disease. This list of lab values is not exhaustive. They are the common labs I look at as a clinician in my practice to search for clues to imbalances in my patients.
80%
Of all autoimmune diseases are diagnosed in women. It can take up to 30 years to develop an autoimmune disease.
This means that most people do not know how to read the early warning signs of autoimmunity. Some of these signs show up in laboratory testing. If you are autoimmune positive, itâ&#x20AC;&#x2122;s important to heal your gut, eat in a non-inflammatory manner, and use this kit:
ACCESS HERE
I test for: Food allergies and sensitivities using the LEAP MRT test. Avoid reactive foods that show up as yellow or red for 6 months. It is very important that we rotate our foods each day. Eating the same thing every day gives your immune system a target. Add each one back at the end of the 6-month period one at a time for 4 days each. Watch for
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symptoms. If you have several allergens, use the Digestive Repair Kit as directed for 12 months:
ACCESS HERE
Viruses I look for Epstein Barr Virus in all of my patients. I have never seen a patient with leaky gut who did NOT have EBV. The Centers for Disease Control (CDC) report that 80% of Americans now have EBV. Healing your leaky gut is the fastest way to put it into remission.
Gut Microbial Imbalance or Dysbiosis When you have leaky gut, you are at high risk for having an imbalance of your intestinal microbes. These critters are essential players in almost every function in your body, including the expression of your very DNA! They number in the 100 trillion, and if out of balance, can cause mood issues, weight problems, gastrointestinal distress, brain fog, memory lapse, and sugar cravings. I use a comprehensive stool analysis to see “who is living down there” with my patients. I often find yeast overgrowth, H. Pylori, small intestinal bacterial overgrowth (SIBO) and/or parasites in my patients who have been doctor shopping and can’t find anyone to help them. I often use this kit after we see what is living in the gut: ACCESS HERE
Try it for 8 weeks while following a low FODMAP and anti-yeast diet and see how you feel.
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Inflammatory Markers HS CRP (High Sensitivity C-Reactive Protein) HS CRP is a protein that increases in the blood with inflammation. Research indicates a reduction in sugar and carbohydrate intake can result in a reduction in HS CRP, elevated triglyceride levels, and hemoglobin A1c. Optimal Adult Range: <03.0
ESR (Erythrocyte Sedimentation Rate): Alerts you to chronic inflammatory conditions and the presence of possible disease. I see this elevated often when patients are eating foods they are sensitive to. Optimal Adult Range: <10
If you have a history of an elevated ESR or HS CRP, make sure you do food sensitivity testing, try InflammaCore, and eat a diet low in foods that cause inflammation:
ACCESS HERE
Autoimmune Markers ANA The antinuclear antibody (ANA) test is used as a primary test to help evaluate a person for autoimmune disorders that affect many tissues and organs throughout the body (systemic). It is most often used as one of the tests to help diagnose systemic lupus erythematosus (SLE). ANA are a group of autoantibodies produced How to Understand Lab Values A Guide to Optimal Health
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by a person’s immune system when it fails to adequately distinguish between “self” and “non-self.” They target substances found in the nucleus of a cell and cause organ and tissue damage. Depending on a person’s signs and symptoms and the suspected disorder, ANA testing may be used along with or followed by other autoantibody tests. Some of these tests are considered subsets of the general ANA test and detect the presence of autoantibodies that target specific substances within cell nuclei, including anti-dsDNA, anticentromere, anti-nucleolar, anti-histone and anti-RNA antibodies. An ENA panel may also be used in follow up to an ANA.
RF The rheumatoid factor (RF) test is primarily used to help diagnose rheumatoid arthritis (RA) and to help distinguish RA from other forms of arthritis or other conditions that cause similar symptoms. While diagnosis of RA relies heavily on the clinical picture, some of the signs and symptoms may not be present or follow a typical pattern, especially early in the disease. Furthermore, the signs and symptoms may not always be clearly identifiable, since people with RA may also have other connective tissue disorders or conditions, such as Raynaud phenomenon, scleroderma, autoimmune thyroid disorders, and systemic lupus erythematosis, and display symptoms of these disorders as well. The RF test is one tool among others that can be used to help make a diagnosis when RA is suspected.
C & P-ANCA Tests for antineutrophil cytoplasmic antibodies (ANCA) may be used to help detect and diagnose certain forms of autoimmune vasculitis, including granulomatosis with polyangiitis (Wegener granulomatosis), microscopic polyangiitis, and eosinophilic How to Understand Lab Values A Guide to Optimal Health
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granulomatosis with polyangiitis (Churg Strauss syndrome). Sometimes this test may also be used to monitor treatment and/or detect a relapse of these conditions. (For more detailed information on these conditions, see the article on Vasculitis.) It also helps distinguish between ulcerative colitis (UC) and Crohn disease (CD), two common types of inflammatory bowel disease (IBD). ANCA are autoantibodies produced by a person’s immune system that mistakenly attack proteins within the person’s neutrophils (white blood cell types).
Try ImmunoGut for active infection and autoimmunity. I have never seen anything work as well as this does to reverse gut and immune system inflammation: ACCESS HERE
Complete Blood Count (CBC) White Blood Cells (WBC) White blood cells kill bacteria and this count is a measure of the body’s response to infection. Optimal Adult Range: 5,000-8,000cu.mm
Common causes of elevated WBCs Active Infections, leukemia, childhood diseases (measles, mumps, chickenpox, rubella, etc. Other causes are asthma, emphysema, adrenal dysfunction, intestinal parasites, and severe emotional stress.
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Common Causes of low WBCs Chronic infections. Other causes are hepatitis, immune dysfunction, and chemical/heavy metal toxicity.
Neutrophils Neutrophils will be elevated with an acute infection. Optimal Adult Range: 35-65% of total WBC
Neutrophils can be elevated with chronic bacterial infections and lowered with chronic viral infections.
Monocytes Monocytes will be elevated in bacterial infections and protozoal infections. Optimal Adult Range: 0-10% of total WBC Common causes of elevated monocytes Bacterial infections and parasitic infections. An increase in monocytes with an increase in basophils and a mild increase of eosinophils may indicate intestinal parasites.
Lymphocytes: Lymphocytes can be elevated in acute and chronic bacterial infections and decreased in viral infection and immune deficiency. Optimal Adult Range: 20-40% of total WBC
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Common causes of elevated lymphocytes can be viral infections. Look for the lymphocytes to be increased to a point that either equals or exceeds the neutrophils.
Eosinophils Eosinophils can be elevated in allergic conditions, skin diseases, and parasitic diseases. Optimal Adult Range: 0-7% of total WBC Common causes of elevated eosinophils are allergic condition (asthma), food sensitivities, and parasitic infections. Other causes are chemical/ heavy metal toxicity, Hodgkinâ&#x20AC;&#x2122;s disease, and ovarian and bone tumors.
Basophils Basophils can be elevated with Infections. Optimal Adult Range: 0-2 percent of total WBC Common causes of elevated basophils are inflammation, childhood diseases (measles, mumps, chickenpox, rubella, etc.), acute trauma and parasites.
Red Blood Cells RBCs are made in the spleen. They indicate the oxygen-carrying ability of the blood. Optimal Adult Male Range: 4.60-6.0 million cu/mm Optimal Adult Female Range: 3.90-5.50 million cu/mm
Common causes of elevated RBCs can be dehydration, respiratory distress, acute poisoning, cystic fibrosis, and Phase 1 adrenal fatigue.
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Common causes of low RBCs can be iron deficiency anemia, internal bleeding, excessive exercise, salicylate toxicity, or lead poisoning.
Hemoglobin Hemoglobin is the main transport of oxygen and carbon in the blood. It is a benchmark for anemia or poor diet/nutrition or malabsorption. Optimal Adult Male Range: 13.5-18.0g/dL Optimal Adult Female Range: 12.5-16.0g/dL Common causes for elevated hemoglobin is dehydration, emphysema, and asthma. Common causes for low hemoglobin are anemia, internal bleeding, and digestive inflammation.
Hematocrit Hematocrit is the measurement of the percentage of RBCs in blood. It is an important determinant of anemia (decreased), dehydration (elevated), or possible over-hydration (decreased). Optimal Adult Male Range: 40.0-52.0% Optimal Adult Female Range: 36.0-47.0% Common causes of elevated and decreased hematocrit are the same as hemoglobin.
Platelets Platelets represent the clotting of the blood. Optimal Adult Range: 200,000-300,000cu.mm Common causes for elevated platelets are arthritis, anemia, How to Understand Lab Values A Guide to Optimal Health
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arteriosclerosis, and blood loss. Common causes for low platelets are Leukemia, liver dysfunction, and chemical/heavy metal toxicity.
Reticulocyte Count Reticulocyte count confirms chronic microscopic bleeding. Optimal Adult Range: 0.5-1.5% A common cause for an elevated reticulocyte count is internal bleeding. Common causes for a low reticulocyte count are vitamin B-12, B-6, and folic acid anemia.
Mean Corpuscular Volume (MCV): Mean corpuscular volume (MCV) is the average volume of red cells. Optimal Adult Range: 81.0-99.0cu.microns Common causes for increased MCVs are vitamin B-12/Folic Acid anemia. Common causes for low MCVs are iron deficiency or internal bleeding.
Mean Corpuscular Hemoglobin (MCH): The â&#x20AC;&#x153;mean cell hemoglobinâ&#x20AC;? (MCH), is the average mass of hemoglobin per red blood cell in a sample of blood. Optimal Adult Range: 26.0-33.0micromicro grams A common cause for an elevated MCH Count is a vitamin B12/Folic acid deficiency. Common causes for low MCH are iron deficiency anemia or internal bleeding.
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Your Digestive System
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Your Digestive System The digestive system is a group of organs working together to convert food into energy and basic nutrients to feed the entire body. Food passes through a long tube inside the body known as the alimentary canal or the gastrointestinal tract (GI tract). The alimentary canal is made up of the mouth, pharynx, esophagus, stomach, small intestines, and large intestines. There are several important accessory organs that help your body to digest food but do not have food pass through them. Accessory organs of the digestive system include the teeth, tongue, salivary glands, liver, gallbladder, and pancreas. It is important to do a liver/digestive cleanse every quarter, or 4 x a year. I like this very simple kit: ACCESS HERE
All autoimmune diseases have at their root an imbalance known as â&#x20AC;&#x153;leaky gutâ&#x20AC;?. I use food sensitivity testing as a benchmark for how well the gut is healing when I have someone on a leaky gut protocol. Testing for liver function is important for understanding how healthy the digestive system is. This is usually accomplished through a complete metabolic panel. A CMP includes:
Globulin Globulins serve to carry some hormones, lipids, metals, and antibodies. High levels are found in liver disease, chronic infections, rheumatoid arthritis, lupus, and myelomas. Low levels are present with malabsorption, liver disease, and kidney disease, and immunocompromised patients.
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Optimal Adult Range: 2.0-4.0 Common causes for elevated globulins are low stomach acid and liver disease. A common cause for low globulin levels can be internal hemorrhage.
A/G Ratio A/G ratio can indicate ulcerative colitis, burns, kidney disease, cirrhosis, and multiple myeloma. Optimal Adult Range: 1.2-1.5
Alkaline Phosphatase Alkaline phosphatase is an enzyme that is found in all body tissues, but the most important sites are bone, liver, bile ducts, and the gut. The alkaline phosphatase test (ALP) is used to help detect liver disease or bone disorders. Clinical Adult Range: 30-115 Optimal Adult Range: 60-80 Common causes for elevated alkaline phosphatase can be bone disease (including a primary bone lesion), liver disease (including an invasive liver lesion), rheumatoid arthritis, excess vitamin D, or bile duct disease. Common causes for low alkaline phosphatase can be low-functioning adrenal glands, hypothyroidism, progesterone deficiency, protein deficiency, malnutrition or a deficiency in zinc.
Transaminases (SGTP/ALT) & (SGOT/AST) These are enzymes that are primarily found in the liver. Alcohol, certain drugs, hepatitis, and liver and bile duct disease can cause an elevation in these liver enzymes. Low levels of GGT may indicate a deficiency in magnesium, while low levels of SGPT and SGOT can indicate a deficiency of vitamin B6. How to Understand Lab Values A Guide to Optimal Health
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SGTP/ALT Optimal Adult Range: 20-30 U/L SGOT/AST Optimal Adult Range: 20-30 U/L
GGT GammaGlutamyl transferase (GGT) is an enzyme involved in glutathione metabolism. Itâ&#x20AC;&#x2122;s found in the liver and will rise with alcohol use, liver disease, or excess magnesium. Optimal Adult Range: 20-30 U/L Common causes for elevated GGT are biliary obstruction, alcoholism, and bile duct and gallbladder inflammation.
LDH Lactate Dehydrogenase (LDH) is an enzyme found in many tissues of the body. Elevated levels can be seen with anemia, hepatitis, other types of liver disease, hypothyroidism, with the use of oral contraceptives, hypoglycemia, inflammation in the tissues, cancers, and many kinds of anemia. Optimal Adult Range: 140-200U/L TOTAL PROTEIN
Total Protein A measurement of the protein in your blood stream. Itâ&#x20AC;&#x2122;s a combination of albumin and total globulin and is impacted by your levels of albumin and total globulin. Elevated protein levels are a red flag to do additional testing for cancer, rheumatoid arthritis, or to correct for dehydration. Low levels are a red flag to increase protein consumption, check for colitis or other kinds of GI inflammation, and to look for over-active adrenals or an under-active thyroid gland. Optimal Adult Range: 7.1-7.6g/dL How to Understand Lab Values A Guide to Optimal Health
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Your Cardiovascular System
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Your Cardiovascular System The heart and circulatory system make up your cardiovascular system. Your heart works as a pump that pushes blood to the organs, tissues, and cells of your body. Blood delivers oxygen and nutrients to every cell and removes the carbon dioxide and waste products made by those cells. A lot of attention has been given to cholesterol as a benchmark for cardiovascular health. This has been over-blown, as science has repeatedly proven that heart health is not just about keeping your cholesterol to a one-size-fits-all level. This Laboratory Guide will highlight a few more values you can ask your medical provider about that have a more direct correlation with preventing cardiac injury and death. Ask for a Boston Heart Labs cholesterol panel to be done. You will get information that will help you know whether cholesterol is even a risk factor for heart disease for you. I love Boston Heart Labs and use them for all of my cardiovascular testing. You will need to find a lab near you that can draw these tests. You can click the links I have provided here to read more about each of the labs I run. I run my cholesterol, cardiovascular genetics, fatty acid balance, and cardiac inflammatory markers with Boston Heart because it gives me what I need to know about my patient’s entire cardiovascular system:
Lipids (cholesterol) • % Small Dense LDL Cholesterol (%sdLDL) • Apolipoprotein A-I (apoA-I) • Apolipoprotein B (apoB) • Apolipoprotein B/Apolipoprotein A-I Ratio (ApoB/ApoA-I) • Direct Low Density Lipoprotein Cholesterol (LDL-C) • High Density Lipoprotein Cholesterol (HDL-C) • High-Density Lipoprotein Cholesterol/Triglycerides Ratio (HDL-C/TG) How to Understand Lab Values A Guide to Optimal Health
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• Lipoprotein(a) (Lp(a)) • Non-High Density Lipoprotein Cholesterol (Non-HDL-C) • Small Dense LDL Cholesterol (sdLDL-C) • Total Cholesterol (TC) • Total Cholesterol/High-Density Lipoprotein Cholesterol (TC/HDL-C) • Triglycerides (TG) • Very Low Density Lipoprotein Cholesterol (VLDL-C) • Very Low-Density Lipoprotein Cholesterol/Triglycerides Ratio(VLDL-C/ TG)
Inflammatory markers: • Fibrinogen • High Sensitivity C-Reactive Protein (hs-CRP) • Lipoprotein-Associated Phospholipase A2 (LpPLA2) • Myeloperoxidase (MPO)
Fatty Acid balance and statin review • Boston Heart Cholesterol Balance® Test • Boston Heart HDL Map® • Boston Heart Prediabetes Assessment® • Boston Heart Statin Induced Myopathy (SLCO1B1) Genotype Test • Boston Heart Fatty Acid Balance™ Test
Homocysteine Elevated levels of homocysteine is a risk factor for heart disease, stroke, and heart attacks. Optimal level is below 8.0. How to Understand Lab Values A Guide to Optimal Health
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The great news is that it’s easy to reduce homocysteine in the blood stream by taking a high quality methyl B and methyl folate supplement such as the Methyl Multi-Vitamin found here:
ACCESS HERE
Potassium Is necessary for heart muscle contractions. Decreased levels can result from chronic use of diuretics, alcohol abuse, kidney disease, over-active adrenals, over-medication with testosterone, and diarrhea. Optimal Adult Range: 4.0-4.6
Metabolic testing (for weight and blood sugar control) • Adiponectin • C-Peptide • Glucose • Glycated Serum Protein (GSP) • Hemoglobin A1c (HbA1c) • Insulin • Insulin Resistance
Cardiovascular Genetics • Apolipoprotein E Genotype Test • Clopidogrel Response (CYP2C19) Genotype Test • Prothrombin (Factor II) G20210A Genotype Test • Factor V Leiden Genotype Test • MTHFR Genotype Test How to Understand Lab Values A Guide to Optimal Health
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It is often hard to lose weight when too many metabolic functions are out of balance. I find that using this kit helps people get those functions back into order:
ACCESS HERE
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Your Urinary System
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Your Urinary System The Urinary System is a group of organs in the body concerned with filtering out excess fluid and other substances from the bloodstream. The substances are filtered from the body in the form of urine. Urine is a liquid produced by the kidneys, collected in the bladder, and excreted through the urethra. One of the common signs of a weak urinary system is frequent urinary tract infections. This is often a sign of an imbalance of microbes in the digestive system.
BUN (Blood Urea Nitrogen) BUN is a waste product produced by protein breakdown in the liver. Elevated levels can be caused by excessive protein intake, kidney damage, some drugs, decreased fluid intake, intestinal bleeding, hard exercise, heart failure or decreased digestive enzyme production in the pancreas. Low levels are usually due to decreased protein intake, malabsorption, or liver damage. Optimal Adult Range: 10-26 mg/dL
Creatinine Creatinine is also a waste product produced by protein breakdown in the liver. Your creatinine level is a benchmark for your bodyâ&#x20AC;&#x2122;s muscle mass. Decreased levels can be from low protein intake, kidney damage, liver disease, or pregnancy, and high levels can be a red flag for kidney damage. Optimal Adult Range: 0.7-1.5 mg/dL
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BUN/Creatinine Ratio An elevated ratio can be a result of dehydration, congestive heart failure, renal failure, prostate enlargement, a high protein diet, circulatory failure, or a urinary obstruction. A low ration might reflect too much fluid intake, pregnancy, or a low protein and high carbohydrate diet. Optimal Adult Range: 6-10
Uric Acid Uric acid is the byproduct of purine metabolism. Elevated levels are found in gout, high protein diets, infections, and kidney disease. Decreased levels might indicate liver damage, protein and molybdenum deficiency, or too much renal acidity. Optimal Female Range: 2.4-6.0 mg/dL Optimal Male Range: 3.4-7.0 mg/dL Common reasons for elevated uric acid are gout, kidney problems, arteriosclerosis, tumors, diuretics, leukemia, mercury or lead poisoning, intestinal obstruction, and arthritis. Some causes for low uric acid include anemia and pregnancy.
Albumin Is the most plentiful protein in the blood stream. Albumin is produced in the liver and is an antioxidant that guards your tissues against the damage that comes from free radicals. It chelates toxins and other waste products and acts as a buffer in the body. It is a major transporter of vitamins, minerals, and hormones. If you eat highly processed foods, have diarrhea, a fever, an infection, or liver or kidney disease, albumin levels will be lower.
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Optimal Adult Range: 3.0-5.5. It is considered a danger sign if albumin sinks below 3.5, along with elevated lymphocytes.
Chloride Is an electrolyte mediated by the kidneys. Electrolytes help to maintain a healthy acidbase balance and aid in regulating blood volume and arterial pressure. Increased levels are partly responsible for acidosis an influx of water crossing the cellular membrane. Optimal Adult Range: 96-110 mmol/L Common reasons for elevated chloride levels include kidney issues, anemia, prostate problems, aspirin poisoning or a high intake of salicylate rich foods, too much salt, dehydration, and metabolic acidosis. Low chloride levels might be from kidney problems, metabolic alkalosis, or a decrease in stomach acid.
Sodium Plays a huge role in the fluid balance of your body. You will see low levels of sodium with over-hydration, heart failure, diarrhea, vomiting, or kidney issues. Elevated levels might reflect an over-consumption of salt or the under-consumption of water. Optimal Adult Range: 140-144
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Nutritional Information
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Nutritional Information Vitamin D3 Is responsible for increasing intestinal absorption of calcium, iron, magnesium, phosphate, zinc, and for hormone balance and gastro-intestinal health. The most important compound in this group is vitamin D3. Optimal Adult Range: 50-90 ng/ml. Research indicates that nearly every adult needs to supplement with vitamin D3. It is easier to absorb and for your body to use if combined with K2. I advise at least 5000-10,000 IU daily of vitamin D3 in a liquid form combined with K2 such as this product:
ACCESS HERE
Calcium Calcium is the most plentiful mineral in the body. It is necessary for bone metabolism, muscular contraction (including the heart), protein absorption, fat metabolism, communication from the nervous system, and blood clotting. It can be altered by levels of other elements like magnesium, iron, and phosphorous, CO2 levels, hormone balance, vitamin D levels, and some medications. Optimal Adult Range: 8.5-10.8 Optimal Common reasons for elevated calcium levels include hyperparathyroidism, thyroid tumors, excess vitamins (like vitamin D), multiple myeloma, adrenal hypofunction, osteoporosis, and ovarian hypofunction. A low level of calcium can be from hypoparathyroidism, low vitamin D levels, celiac disease, heavy metal toxicity, pregnancy, low stomach acid, and renal issues. The correct ratio of calcium and magnesium is essential for proper function.
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This is one such product with the correct ratio and is of high quality plus a good value:
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Magnesium Is found in the bone, muscles, arteries, heart, nerves, and teeth. Optimal Adult Range: 1.7-2.4 Common reasons for elevated magnesium levels include renal or heart disease and excessive use of antacids containing magnesium.
Phosphorus Works with calcium in the development of bones. It is also an important player for the proper function of nerves and muscles. Elevated levels are often seen with kidney disease, over-consumption of soft drinks and sugary snacks, and parathyroid problems. Low levels of phosphorous can be a result of too little stomach acid. Optimal Adult Range: 2.5-4.5
Iron and Ferritin Iron aids in the transport of oxygen with hemoglobin. The most important test for iron and to determine whether supplementation is necessary is serum ferritin. If ferritin levels are within optimal range, then the problem is in the metabolism or iron rather than iron deficiency or overload. Iron Optimal Adult Range: 75-150 mg/ml
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Ferritin Optimal Adult Range: 70-90 ng/mL or mcg/L Common reasons for elevated iron levels include hereditary hemochromatosis or secondary hemochromatosis. Secondary hemochromatosis can be a result of liver disease, excessive iron intake, a yeast overgrowth in the gut, intravascular hemolysis, or thalassemia. Low levels can be a result of low ferritin levels, nutritional problems, blood loss, too little stomach acid, liver or kidney disease, and small bowel disease.
B vitamins The B vitamin group consists of eight B vitamins. They are commonly recognized as a group and do work together, but each of the B vitamins performs exclusive functions. Here is a guide to each member of this family of vitamins. Taking a high quality supplement with the correct ratios PLUS a methylated version of folate and B12 helps to make sure you get what you need in terms of energy production:
ACCESS HERE
Thiamin or B1 Is essential in the production of energy from your food. It also supports your nervous system and aids in carbohydrate metabolism. It can be found in lentils, whole grains, red meats, nuts, sunflower seeds, peas, cauliflower, spinach, and legumes. In whole blood, the reference range of vitamin B1 (thiamine) is 2.5-7.5 Îźg/dL, or 74-222 nmol/L.
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Riboflavin or B2 Supports cellular energy production and the prevention and reduction of migraine headaches. Riboflavin is found in a variety of foods such as eggs, salmon, beef, spinach, and broccoli. The reference range of plasma vitamin B2 (riboflavin) is 1-19 μg/L.
Niacin or B3 Supports cellular energy production and helps support cardiovascular health. Good sources of niacin include beef, poultry, and fish, as well as peanuts and lentils. Optimal Adult Reference Range: 1-8.0 ug/mL
Pantothenic acid or B5 Helps support cellular energy production in the body. Sources include organ meats (liver, kidney), egg yolk, whole grains, avocados, cashew nuts, peanuts, lentils, soybeans, brown rice, and broccoli. Optimal Adult Reference Range: 60 - 147 ug/L
Pyridoxine or Vitamin B6 Is involved in over 100 cellular reactions throughout the body and is essential in keeping a variety of functions operating optimally. Vitamin B6 helps to metabolize amino acids and glycogen (the body’s storage form of glucose), and is also necessary for normal nervous system function and red blood cell formation. It can be found in foods such as meat, poultry, eggs, bananas, fish, and cooked spinach. Optimal Adult Reference Range: 25-50 μg/L
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Biotin or vitamin B7 Helps support healthy hair, skin, and nails. It also aids in carbohydrate, protein, and fat metabolism and is commonly found in foods such as brewer’s yeast, strawberries, and organ meats. Optimal Adult Reference Range: 221.0 – 3004.0 pg/mL
Folic Acid or Vitamin B9 Is most commonly known for its role in fetal health and development as it plays a critical role in the proper development of the baby’s nervous system. With the advent of direct-to-consumer genetic tests, we are finding that about 35% of the population struggle with the metabolism of B12 and B9 and require methylated versions of them. Good nutritional sources are dark green leafy vegetables, asparagus, and spinach as well as brewer’s yeast, liver, beets, dates, and avocados. Optimal Adult Reference Range: 10-20 ng/mL, or 25-45.3 nmol/L
Cobalamin or Vitamin B12 Plays a critical role in the pathways of the body that produce cellular energy. It is also needed for DNA synthesis, proper red blood cell formation, and for normal nervous system function. Again, with the advent of direct-to-consumer genetic tests, we are finding that about 35% of the population struggle with the metabolism of B12 and B9 and require methylated versions of them. People who follow vegan or vegetarian diets may benefit from a methylated B12 supplement, since B12 is predominantly found in foods of animal origin such as chicken, beef, fish, and eggs. Optimal Adult Reference Range: 600 and 900 pg/m
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If you are struggling with a health challenge that you cannot solve, you can set up a one-to-one health consultation with me. “Testing and not guessing” is an essential part of your journey back to wellness. Now you have a tool in your hands that can help you understand your test results. If you still need a more personalized, individualized plan of action, contact my team.
Here’s to your health! Love,
Dr. Keesha
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