Comprehensive Blood Work Analysis

Are you tired of blood work coming back normal even though you still don’t feel well?

This is a phrase we hear in our office over and over again when meeting new patients.

Just because things look “in range” however does not mean that everything is necessarily normal, and if you are not feeling like yourself, we can help figure out where deficiencies lie even in what seems like normal blood work.

The first reason for the confusion is that lab ranges have widened overtime and include a huge subset of the population. Oftentimes, being on the low or high end of the range can be very significant and indicate deficiencies and abnormalities. Ranges are based on the 95th percentile and are derived by taking a huge sample of the population. Because people fall all over the map, ranges seldom indicate optimal levels.

Secondly, typical physicals only test for the basics which are very often normal because if those were off, a person would be very sick. However these reports miss a large amount of important markers that can identify underlying problems. We request a much more comprehensive panel and then analyze it with optimal ranges in mind. Our interpretation takes into account many biochemical pathways and because everything in the body is very closely connected, markers can be linked to various areas of the body.

We tirelessly study trends and have analyzed thousands of blood work reports over the last 10 years in practice and thus can look at your blood work with a new set of eyes finding things that can signify the root cause of your issues that traditional approaches may often miss.

Here is a sample of a “normal” blood test result from a person who came in complaining of weight gain, constantly feeling cold, tired and achy all over.

NAME RESULT LAB RANGE
COMPLETE BLOOD COUNT
White Blood Cell (WBC) 3.9 3.8-10.8
Red Blood Cell (RBC) 4.9 4.7-6.1
Hemoglobin (HB/Hgb)) 11.9 11.7-15.5
Hematocrit (HCT) 45 42-52
Mean Cell Volume (MCV) 85 80-100
Mean Cell Hemoglobin (MCH) 29 27.0-32.0
Mean Cell Hb Conc (MCHC) 33.3 32.0-36.0
Red Cell Dist Width (RDW) 14.4 11.5-14.5
Platelet count 180 150-450
Mean Platelet Volume 7.9 7.5-11.0
WBC Differential
Neutrophil (Neut) 45 40-75
Lymphocyte (Lymph) 41 15-42
Monocyte (Mono) 8 0-10
Eosinophil (Eos) 3 0-5
Basophil (Baso) 1 0-2
Thyroid Panel
TSH 4.3 .4-4.5
Total T4 5.5 4.5-12
Free T4 0.9 .8-1.5
B12
B12 268 211-950
Comprehensive Metabolic Panel
Glucose 85 65-99
Bilirubin, Total 1.1 0-1.2
Alkaline Phosphatase 41 40-150
AST 34 0-35
ALT 38 0-40

 

As you can see, everything “seems” in range, however these ranges are far from optimal and many things are missed.

Below is the same results with optimal ranges:

NAME RESULT LAB RANGE
COMPLETE BLOOD COUNT
White Blood Cell (WBC) 3.9 4.3-10
Red Blood Cell (RBC) 4.8 4.7-6.1
Hemoglobin (HB/Hgb)) 11.9 13.5-14.5
Hematocrit (HCT) 45 42-52
Mean Cell Volume (MCV) 85 80-100
Mean Cell Hemoglobin (MCH) 29 27.0-32.0
Mean Cell Hb Conc (MCHC) 33.3 32.0-36.0
Red Cell Dist Width (RDW) 14.4 11.5-14.5
Platelet count 180 150-450
Mean Platelet Volume 7.9 7.5-11.0
WBC Differential
Neutrophil (Neut) 45 40-75
Lymphocyte (Lymph) 41 20-38
Monocyte (Mono) 8 0-10
Eosinophil (Eos) 3 0-3
Basophil (Baso) 1 0-2
Thyroid Panel
TSH 4.3 1.8-3.0
Total T4 5.5 6-12
Free T4 0.9 1-1.5
B12
B12 268 500-950
Comprehensive Metabolic Panel
Glucose 85 65-99
Bilirubin, Total 1.1 .2-.9
Alkaline Phosphatase 41 45-150
AST 34 10-32
ALT 38 10-35

As you can see, this person has a low white blood cell count which indicates a weakened immune system and a potential chronic infection. Furthermore, the lymphocytes are elevated letting us see the the infection is most likely viral. This is something that can account for them feeling achy and tired.

The hemoglobin is very low thus showing low iron which often lead to fatigue and feeling cold. Furthermore, iron metabolism is a complex pathway and in order to assess it completely, there are a few other markers such as Total Iron, Iron saturation, Ferritin and TIBC. We request all the iron markers and look at them as a whole to analyze iron status and decide if and what kind of supplementation would be necessary.

Alkaline phosphatase is low. Typically only very high levels are flagged as that can mean bone damage, however a low level can signify a zinc deficiency. Zinc is essential for immunity, proper growth, skin health and free radical protection.

Thyroid is also off here with a TSH that is too high and T4 that is too low thus showing an issue with thyroid we can already see.  Thyroid is responsible a multitude of functions in the body including energy, temperature control and metabolism just to name a few. Also, just looking at TSH and T4 is not truly complete for a full thyroid work up and many thyroid problems can be missed in this way. When evaluating thyroid, we not only look at TSH and T4 but we also look at Total and Free T3, Reverse T3 and thyroid antibodies to get a complete picture. T4 is converted to T3 in the liver and then used by all of your cells. It is quite common for patients with toxins, genetic predispositions or adrenal issues to not have optimal conversion and thus we cannot assume that T3 will be ok just because T4 is in range.  To learn more about this, please take a look at our informative yet very easy to understand Thyroid Article

While B12 looked in range in the regular report, you can see from the above that the optimal range for B12 is much higher than the lab range thus showing this person has a B12 deficiency. B12 is essential for proper nervous system function and energy, thus a low level is likely to contribute to fatigue.

There are also many parameters that were not originally requested such as Homocysteine, Hs CRP and ANA that would be very helpful in further evaluation of symptoms.

Once we get all of your results, we can gain a lot of insight into the workings of your system and devise a plan to naturally balance the markers that need attention.