How to read a basic lab (blood)

Standard

It has been 2 years since my last blood work was done. It is recommended to have your blood sugar checked every year and your cholesterol checked every 5 yrs (if it is normal). But you may not know that healthcare providers do not check their blood on a regular basis (me :D). They tell patients to exercise at least 3 times a week, get your physical exam every year, do your pap smear every year, etc. but they themselves do not follow those recommendations. Anyway, I have dragged myself to the doctor’s office today to get an order for basic labs. I should have asked her to order the comprehensive metabolic panel (CMP) and complete blood count (CBC) but I forgot. Basic chemical panel only shows electrolytes, blood sugar and kidney function whereas CMP is basic panel plus nutrition status and liver function. CBC can tell you about red blood cell, white blood cell so that infection or anemia can be discovered. Also, my blood pressure (BP) at the office was 137/80 >.<, too high. It has been always high at that office. I did not know why. I checked my blood pressure at home before I came in and it was normal. They used the automatic machine while I used the manual monitor with the stethoscope. The normal BP should be less than 120/80. I have high risk of hypertension because both my parents and my grandparents both sides have it. I have been cautious on my sodium intake but I guess I have to exercise more. By the way, the medical assistant measured right after I sat down and made me talk while measuring. The right way to do is to let patient rest a little bit after they sit down and patient should not talk while the blood pressure is measured. She was just too busy to take time.

So after I got my order, I went to the lab in the hospital around 11 am and came back for the results at 4pm. It was quick. By the way, I was fasting at least 12 hours before the blood was drawn. My doctor asked me to make the next appointment so that she could go over the lab with me. However, because I knew how to interpret the lab, I told her that I would not come back if everything was normal and she agreed. (I did not want to pay another copay if everything was normal)

Here are my results:

BUN (Blood Urea Nitrogen) and creatinine are used to evaluate kidney function because they are eliminated by kidney. Higher value than normal usually indicates a problem in kidney. Mine is a little bit low, probably due to overhydration. The electrolytes include Na (sodium), K (potassium), Calcium, Chloride. These should be in normal range, high or low may indicate a health problem. CO2 is the base whereas Chloride is the acid. If one or the other shifts away from normal, it means your blood pH is affected. Anion gap is the difference between cations (electrolytes with positive charge such as Na, K, Ca) and anions (negative charge electrolytes such as Cl and HCO3). In practice, because K and Ca concentrations in the blood are too low, only Na is counted in the equation: Anion gap= Na – (Cl + HCO3). Anion gap is used to find out the cause of excess acid in your blood. I feel like I am teaching chemistry 101. I do not want to go into details about electrolytes because they are really complicated. In case you want to find out more, you can always go to here at Medline website, a government site. I highly recommend government websites when you look up health information because they have reliable sources. Overall, my BMP looks normal, blood sugar is 79 (yay!).

Let’s continue to lipid panel. I still need to work on my LDL to be less than 70 and HDL to be at least 50. HDL is the good cholesterol while LDL is the bad guy. HDL can be obtained by exercising or taking Niacin which is vitamin B3. The higher the HDL the better because it helps remove LDL, the bad guy. Another bad guy is triglycerides. If triglyceride level is too high, it will affect pancreas. Taking omega-3 will help lower triglycerides. You can obtain omega-3 via eating cold water oily fish or taking supplements. I miss marine fish because I am living in the mountain so there are not many choices in the market. A lot of my friends here do not eat fish or seafood because they do not like the smell and the taste. I wonder if I let them try my Vietnamese fish sauce, he he.

How often do you have your blood work done? Do you have your physical exam every year? I hope you will look at your HDL when you have your cholesterol checked next time. Also, it is a good idea to keep copies of lab results for yourself, so you can bring them to a new doctor to show your medical history. Most of the time patients let the doctors keep all records and they do not have any copy. It is ok if you go to the same doctor, but there will be time you will go see a new doctor. Always ask for second opinion in case of surgery or important procedure in case of mis-diagnosis. Also, check your blood pressure once a week. Learn how to use the manual monitor because it is more accurate but the automatic machine is easier to use. I know many people have stroke due to high blood pressure, including my grandma, my grand-uncle, and my friend’s father. High blood pressure is dangerous because it rarely has symptoms, so it is called silent killer. Learn to protect yourself as well as your family member, especially your parents.

My next post will be about my 401k plan. Let’s go back to investment even though the Dow and S&P has been down the past 2 weeks :(.

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