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Tests Results Explained
This GUIDE is a brief description of the tests performed as part of your "Health Awareness Screening". It is very possible that some of the results described herein do not appear on your profile, and visa-versa. These tests are often considered screening tests to help determine if additional tests are necessary.

Reference Ranges
The reference ranges are based on a comparable set of values obtained from similar healthy subjects. It is possible that an abnormal value may be normal for you but they should be discussed with your physician as only they are qualified to make a determination as to the significance and/or make a diagnosis.

Prevention
One purpose of this screening is to prevent disease before symptoms occur. In those instances where symptoms have developed, laboratory tests results help confirm that a problem does exist. But a normal test result is just as significant as an abnormal result. A normal result does not mean that a test was unnecessary. When a result is normal, it not only helps rule out disease, but is also establishes a baseline "normal". A person’s own result is the best baseline for monitoring any change that takes place in the future.

% Saturation (Transferrin Percent Saturation)
A/G Ratio
Albumin
Alkaline Phosphatase
BUN (Blood Urea Nitrogen)
BUN/Creatinine Ratio
Calcium
Cardio CRP (high sensitivity C-reactive Protein)
Chloride
Cholesterol
Cholesterol/HDL Ratio (Coronary Risk Factor)
COMPLETE BLOOD COUNT (CBC)
Creatinine
Direct Bilirubin
Ferritin
GGT (Gamma-Glutamyl Transferase or transpeptidase)
Globulin
Glucose
HDL
Hematocrit
Hemoglobin
Inorganic Phosphorous (Phosphate)
Iron
LD (Lactate Dehydrogenase) or LDH
LDL
Magnesium
Mean Platelet Volume (MPV)
Platelet Count
Potassium
Protein Bound Glucose
RDW (Red Cell Distribution Width)
Red Blood Cell Count (RBC)
Red Blood Cell Indices (MCV, MCH, MCHC)
SGOT (AST)
SGPT (ALT) Alanine Aminotransferase
Sodium
TIBC (Total Iron Binding Capacity)
Total Bilirubin
Total Protein
Triglycerides
Uric Acid
White Blood Cell Count (WBC)

% Saturation (Transferrin Percent Saturation)
This percent is obtained by comparing the iron level to the TIBC level. It is a simple way to compare the amount of iron in the blood to the capacity of the blood to transport iron.
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A/G Ratio
The A/G (Albumin/Globulin) ratio is usually between 0.9 and 3.6. Once considered to have some relevance in differentiating protein abnormalities and various diseases, today the ratio is not considered significant.
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Albumin
Approximately two-thirds of the total protein circulating in the blood is albumin. This important protein keeps water inside your blood vessels. When your albumin level is too low, water can leak out of the blood vessels into other parts of your body and cause swelling. A low level of albumin can be caused by malnutrition, too much water in the body, liver disease (albumin is made by the liver), kidney disease, severe injury such as burns or major bone fractures, and slow bleeding over a long period of time.
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Alkaline Phosphatase
Alkaline phosphatase is an enzyme that is found in almost all tissues of the body, but the most important sites are bone and liver. A high level of alkaline phosphatase in your blood may indicate bone, liver or bile duct disease. Certain drugs may also cause high levels. Growing children because of bone growth normally have a higher level than adults. Minor increases are sometimes observed during the normal aging process.
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BUN (Blood Urea Nitrogen)
BUN is a waste product derived from protein breakdown in the liver. It is excreted by the kidneys. When your kidneys are not working well, the level of BUN in the blood will rise. Dehydration and blood loss can also cause a high BUN level as well as Urinary Tract Infection, congestive heart failure and GI bleeding. A low BUN level may be caused by liver disease, a low protein, high carbo diet, or too much water intake.
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BUN/Creatinine Ratio
This ratio is useful when BUN is elevated. A comparison of the BUN level in the blood to the creatinine level can help determine if a high BUN level is caused by a kidney problem or from something like dehydration or blood loss into the gut.
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Calcium
Calcium is one of the most important elements in the body. Ninety-nine percent of the calcium in the body is in the bones. But the other one percent is very important for the proper function of nerves, enzymes, muscles, and blood clotting. Low levels of calcium in the blood are associated with malnutrition. High levels can be caused by bone disease, excess intake of antacids and milk (often seen in people with ulcers), excess intake of Vitamin D, and hyperparathyroidism. The parathyroid gland is the main regulator of calcium in the body responsible for maintaining an equilibrium state. Therefore, calcium levels can not be interpreted as an indicator of osteoporosis.
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Cardio CRP (high sensitivity C-reactive Protein)
Reference Ranges:

Less than 1 mg/L Low Risk
Between 1 – 3 mg/L Average Risk
3.1 – 10.0 mg/L Indicated high risk
Greater than 10.0 Persistent elevations may represent non-cardiovascular inflammation

Cardio CRP (highly sensitive C-Reactive Protein) is a sensitive marker of systemic inflammation, which plays a role in the initiation and progression of atherosclerosis, the underlying cause of MI. It detects levels of inflammation as low as 0.175 mg/L as opposed to standard CRP assays, which cannot detect CRP levels less than 3.0 mg/L.

Because of the extreme sensitivity of this test, patients may see elevated values in their test results resulting from acute (temporary) inflammation from a recent injury, fall, infection, cold, allergic reaction, bruise, stress, etc, and likewise could see low values after taking an anti-inflammatory ibuprofen. The real concern for identifying persons at risk as a result of elevated CRP (hs) is chronic (long-term) inflammation caused by number of factors. The familiar ones are high blood pressure, smoking, diabetes, high blood pressure and obesity. Other chronic infections linked to elevated CRP levels include periodontal (gum) disease, ulcers, and even sexually transmitted diseases.

A CRP value > 5 mg/L may indicate an acute inflammatory process, and sampling should be repeated at least 2 weeks later. Elevated results from acute inflammation will usually return to normal within 10 days assuming the cause has been alleviated.

Chloride
Chloride is probably the least important element measured in the blood. It is almost never the only element that is high or low. It is usually associated with an high or low level of sodium or potassium. Borderline high or low levels of chloride have very little significance.
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Cholesterol
Cholesterol is a normal constituent of the blood and becomes a problem only if too high as elevated cholesterol levels are strongly associated with heart disease. Your body uses cholesterol to make essential body substance as cell walls of the retina and hormone production. Your liver manufactures 70 – 80% of your bodily cholesterol needs; the remainder comes from dietary intake. Besides changes in diet, low and high values can be associated with thyroid disorders, stress, caffeine, and even little nuances as posture when being drawn. Therefore patients should not be alarmed with small swings in absolute values, but consider the range over several tests.
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Cholesterol/HDL Ratio (Coronary Risk Factor)
This number is obtained by comparing the total cholesterol level to the HDL cholesterol level. The higher this ratio, the greater the risk for coronary disease. A high HDL will result in a lower ratio, meaning a lower risk. This can be true even if total cholesterol is elevated. It is this ratio that appears to best measure a person’s risk for developing CHD and is very important when assessing a patient. Coronary Risk Factor guidelines are as follows.

Coronary Risk Factors
Men Women Risk Factor
3.4 3.3 1/2 Average Risk
5.0 4.4 Average Risk
9.6 7.1 2X Average Risk
24.0 11.0 3X Average Risk

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COMPLETE BLOOD COUNT (CBC)

The CBC provides information pertaining to three kinds of cells in the blood – the production of red blood cells (RBC), the production of white blood cells (WBC) and Platelets. The CBC is most frequently used as a screening test, as an anemia check, and as a test for infection, but it is also used in the diagnosis and treatment of a large number of other conditions.
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Creatinine
Creatinine is the breakdown product of creatine, which is used for skeletal muscle contraction, and is excreted entirely by the kidneys. Unlike BUN it is little affected by dehydration, malnutrition or liver function. High levels usually indicate a deterioration in kidney function.
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Direct Bilirubin
This is usually ordered as an ad-on test for a specific form of bilirubin that is formed in the liver and excreted in the bile. Normally very little of this form of bilirubin is found in the blood. However, in liver disease, some of this form leaks into the blood so even a slightly high level of direct bilirubin indicates a problem with the liver cells.
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Ferritin
Ferritin is the most reliable serum indicator of total stores of iron in the body and is a convenient means of diagnosing iron deficiency anemia, iron overload conditions and also distinguishing between iron deficiency anemia and the anemias of inflammation or chronic liver disease in which iron stores and ferritin are generally increased. Ferritin levels are decreased in anemias due to iron deficiency, chronic or acute hemorrhage, and aplastic anemia. Ferritin levels are increased in anemias due to inflammations, chronic liver disease and leukemias. Recently the level of one’s iron stores took on further significance when a study released from Finland (1992) drew a strong association between high levels of stored iron (over 200 ng/ml) and coronary risk, especially when abnormally high levels of LDL are present.
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GGT (Gamma-Glutamyl Transferase or transpeptidase)
This is an enzyme that is found primarily in the liver cells. The inference is that cells are dying and releasing their enzymes to keep energy production up to par.

Decreased values are not clinically significant, but elevated values are a hint that there is liver trouble, and are most often associated with alcohol abuse.

There are, however, other liver enzymes that almost always rise together with GGT and thus a solo rise in GGT is in itself not a reliable marker for alcohol abuse, but certainly a "red flag" and retesting at a later date is advisable.

Certain medications, liver disease or bile duct disease can cause elevated levels.
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Globulin
This is the group of proteins in your blood that helps to fight infections. It is actually comprised of about 60 different proteins including alpha, beta and gamma globulins. Some of the proteins in this group play an important role in clotting and unclotting. Having a high or low level of this protein may indicate the need for further testing of the individual proteins that make up this group.
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Glucose
This is the chief source of energy for all cells of the body. Insulin, which is secreted by the pancreas, controls the rate at which glucose is metabolized. A high blood glucose (>120 mg/dl) level in someone who has fasted for 10-12 hours may be an early sign of diabetes. It may also indicate other problems (for instance, hyperthyroidism). A low glucose level (<40 mg/ dl) may mean too much insulin in your blood resulting in hypoglycemia. On the other hand, low levels may also result from improper specimen preparation and require a redraw.
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HDL
High Density Lipoprotein (HDL) is considered the “good” cholesterol. One of the important roles of HDL cholesterol in the body is to carry cholesterol away from your arteries to your liver for metabolism. The more HDL cholesterol you have, the more cholesterol can be carried away and not clog your arteries. There is growing evidence that a low HDL cholesterol level correlates to an increased risk for CHD, therefore low HDL (<35mg/dl) is classified as a major risk factor. Higher values of HDL are generally found in people who exercise regularly, don’t smoke and maintain a normal weight.
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Hematocrit
This test measures the portion of the blood volume that is made up by red blood cells. A hemotocrit of 40 means that 40% of the red blood cells are composed of red cells. This test is used to test for anemia. The results of this test will show you whether you are anemic (low volume of red blood cells), polycythemic (too many red blood cells), or normal.
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Hemoglobin
Hemoglobin is the iron-containing protein found in red blood cells which form an easily reversed bond with both oxygen and carbon dioxide, thus enabling the red blood cells to function as the oxygen transport system to the tissues of the body (see “Red Blood Cell Count”). The hemoglobin level is thus a good indication of the body’s oxygen carrying capacity. Low and high values are found in patients with anemia and polycythemia respectively.
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Inorganic Phosphorous (Phosphate)
Phosphorous is closely associated with calcium in bone development. Approximately 85% is found within the bone in a complex with calcium, the remaining 15% exists in the blood as a phosphate salt. The phosphate level in the blood is very important for muscle and nerve function. High levels of serum phosphorous an be caused by hypoparathyroidism, kidney failure or increase dietary intake. Very low levels of serum phosphorous can be caused by starvation or malnutrition and this can lead to anorexia muscle weakness.
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Iron
The body must have iron to make hemoglobin and to help transfer oxygen to the muscles. Low iron levels are characteristic of many diseases including iron deficient anemia. Causes of iron deficiency are (1) insufficient iron intake (2) inadequate absorption of iron from the intestines (try drinking orange juice in morning) (3) increased requirements for iron as in growing children (4) loss of blood is in excessive menstruation, bleeding ulcer. Because serum iron levels may vary significantly during the day, specimens should be drawn in the morning. If the body is low in iron, all body cells, particularly muscles in adults and brain cells in children, do not function up to par. On the other hand, if there is too much iron in the body, this can cause injury to the heart, pancreas, joints, testicles, ovaries, etc. Iron excess is found in the hereditary disease called hemochromatosis and this disease can be found in about 3 out of every 1000 people.
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LD (Lactate Dehydrogenase) or LDH
The most common source of LD is the heart, liver, muscles, and red blood cells. LD is thus released into the blood when one of these organs or cells are damaged in some way including extreme vitamin deficiency and certain anemias resulting in red cell destruction. Slightly elevated values are common and usually do not indicate disease. Very high LD values can be the result of improper blood collection procedures.
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LDL
Low Density Lipoprotein (LDL) is generally referred to as the “bad” cholesterol or the atherogenic component of the lipoproteins responsible for depositing cholesterol onto the artery walls. Elevated LDL is strongly associated with heart disease although not a predictor. LDL is a calculated value, according to Friedewald formula: LDL=T.Chol-HDL-Trig/5. When Triglycerides are greater than 400 mg/dl, the calculation is invalid. Trig/5 actually represents the calculation for VLDL or Very Low Density Lipoprotein.
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Magnesium
An optional component of the MasterChemistry, this element is found primarily inside the cells of the body. A low magnesium level in the blood may indicate severe malnutrition, alcoholism, or excessive use of diuretics. A very low level of magnesium in the blood can cause your muscles to tremble.
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Mean Platelet Volume (MPV)
Normal Values: 7.4 - 10.4 fl (may vary from lab to lab) 25um in diameter

This analyte is not included on many lab reports unless specifically ordered by a physician to determine various hematologic disorders, such as thrombocytopenic purpura, leukemia, and evaluation of alcholics under treatment.

An elevated MPV is usually accompanied by analytes of the complete blood count being out of reference range. Slightly elevated or decreased MPV values if the rest of the CBC is normal are usually not significant. Values 15% out of range should be referred to a physician to determine cause.
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Platelet Count
This test measures the number of platelets in a cubic millimeter of blood. Platelets (thrombocytes) are tiny cell-like structures which play a major role in blood clotting. When bleeding occurs, the platelets swell, stick together, and form a sticky plug that helps stop bleeding. Platelets are produced in the bone marrow and thus can be low in bone marrow disease, after excessive radiation or chemotherapy, or anemias caused by B12 or folic acid deficiency. Increased platelet count may be found in certain type of cancers, infections, pregnacy, strenuous exercise, iron-deficiency anemia, removal of the spleen, and inflammatory disorders. Decreased values (less than 50 thousand/cmm) can result in spontaneous bleeding.
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Potassium
This element is found primarily inside of cells and helps regulate the electrical activity of the muscles, including the heart, and affects the acid-base and fluid levels in the body. Unusually high or low levels are most often the result of taking certain drugs or supplements and can be of critical clinical significance. Low levels can be found in patients on diuretics or in patients not receiving enough potassium. A low potassium level can cause muscle weakness and heart problem. A high potassium level can be found in kidney disease or in overuse of potassium supplements.
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Protein Bound Glucose
This new optional ad-on test measures the amount of glucose that circulates in your blood bound to protein. PBG levels provide an indication of your average blood glucose level over the preceeding 7 - 15 days, and help to confirm the glucose result you have today. The combination of the PBG result and the glucose result provide a much better indication of your body’s glucose metabolism than either test alone.
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RDW (Red Cell Distribution Width)
RDW is a fourth index number included by some labs in conjunction with MCV as a diagnosis for red blood cell disorders. A high RDW value indicates excessive variation in size between individual and red blood cells which may be a feature of any disease affecting the blood.

RDW: Normal High Normal
MCV: Low Low Normal
Thalassemia Iron Deficiency Normal
RDW: High Normal High
MCV: Normal High High
Early Iron Aplastic Anemia Vitamin B12 or
Vitamin B12 or Folate deficiency
Folate deficiency
Sickle Cell Anemia

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Red Blood Cell Count (RBC)
The red blood cells, packed with hemoglobin, have the primary function of transporting oxygen from the lungs to the tissues, and returning carbon dioxide back to the lungs to be exhaled. Normal values are slightly less for women and even less for children and infants. The RBC test determines the number of red blood cells in one cubic millimeter of blood. If the RBC is low (anemia), the body tissues may not get all the oxygen it needs. If it is too high (polycythemia), the blood cells may be at increased risk of clumping together in the smallest blood vessels (capillaries). Polycythemia may be due to lack of oxygen to the tissues (high altitude, smoking, chronic lung disease) or a decrease in body fluid volume usually accompanied by loss of iron (low fluid intake, vomiting, diarrhea, profuse sweating).
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Red Blood Cell Indices (MCV, MCH, MCHC)
The indices described the size and hemoglobin concentration of red blood cells. Greater than normal values suggest anemia due to deficiency of folic acid or vitamin B12 A high MCV is also found with alcoholism. Less than normal values are consistent with iron deficiency anemia or thalassemia (an inherited defect of hemoglogin).

MCV (Mean Corpuscular Volume) -
indicates whether the cells are of normal size.

MCH (Mean Corpuscular Hemoglobin) -
gives the weight of hemoglobin in an average red blood cell.

MCHC (Mean Corpuscular Hemoglobin Concentration) -
is the amount of hemoglobin in an average red blood cell.

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SGOT (AST)
The enzyme SGOT (often called serum asparate transaminase, AST) is found in high concentration in the heart and liver and in moderately large amounts in the skeletal muscle, kidneys and pancreas. After myocardial injury, the SGOT level rises within 6 to 10 hours, peaks at 12 to 48 hours, and returns to normal in approximately 3 to 4 days. A characteristic rise in SGOT level occurs in more than 95% of patients with proven myocardial infarction.
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SGPT (ALT) Alanine Aminotransferase
This enzyme, unlike the other enzymes which are produced in other cells besides the liver (such as lung, kidney and muscle) SGPT is found mainly in the liver. If this level is high, your doctor will probably order the test repeated. If it is high on the second sample, it strongly suggest liver disease and further testing for hepatitis.
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Sodium
One of the four major electrolytes, sodium is essential to maintaining the body’s water balance, its acid-base balance and the proper electrical activity of nerves and muscles. A high level can be caused by too much salt intake or by not drinking enough water and can result in water retention. A low level can be caused by fluid loss from dehydration, diarrhea or vomiting.
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TIBC (Total Iron Binding Capacity)
Iron is transported in your blood bound in a protein called transferrin. Transferrin transports the iron in your body from the iron storage sites to where it is needed. It also transports the iron when not needed back to the storage sites. A low TIBC suggest malnutrition or iron excess. A high TIBC suggest iron deficiency. In either case a Ferrintin test is usually ordered.
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Total Bilirubin
Bilirubin is the orange-yellow pigment formed by the spleen during the breakdown of hemoglobin (red blood cells) in the blood that makes the plasma or serum part of your blood yellow. When the bilirubin level in the blood is very high for a period of time, the whites of your eyes and your skin may become yellow – this is known as jaundice. It is transported to the liver for excretion by attaching to the blood protein “albumin”. A high bilirubin level in the blood can be caused by too many red cells being destroyed (hemolytic disease), by liver disease, or by a blockage of bile ducts. Fasting can also cause a slight increase in total bilirubin.
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Total Protein
This figure generally reflects the body’s nutritional state, and is the sum of the albumin and globulin figures. High and low levels don’t necessarily indicate disease, but may indicate the need for further testing.
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Triglycerides
This is a blood fat. The relationship of moderate elevations to higher risk for heart disease is controversial unless cholesterol is also high. An excessive amount of triglycerides (>450 mg/dl) in the blood can contribute to arterial hardening (atherosclerosis) due to fatty deposits. High triglycerides are generally caused by high dietary intake of carbonhydrate, alcohol, sugars and yeast breads and are best treated with a change in diet unless a familial trait.
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Uric Acid
Uric acid is the end product of the breakdown of purines in your body. Purines are an important component of proteins. A high level of uric acid in your blood (often referred to as the “King’s Disease” may cause gouty arthritis or kidney stones. The level of uric acid in the blood is affected by a diet rich in purines – food such as kidney, liver, pancreas and sweetbreads. Also stress, alcohol and certain diuretics may raise the level. Decreased levels are not associated with any clinical symptoms and can be the result of poor kidney function.
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White Blood Cell Count (WBC)
The white blood cells are an important part of the immune system for fighting off infection. There is normally about one white blood cell for every five hundred red blood cells, but if a bacterial infection is present, the number of white blood cells may increase dramatically. The WBC may or may not increase in viral infections. An increased WBC is called leukocytosis and may suggest acute bacterial infection, tissue damage (e.g., heart attack, cancer, cirrhosis of the liver, burns), collagen disease (e.g., rheumatoid arthritis), smoking, severe stress, surgery, fever) or any of a variety of other diseases (e.g., kidney failure, anemia). Very high levels may suggest leukemia. Certain medications including aspirin and several antibiotics may cause elevated values. A decreased WBC value is called leukopenia and may indicate a disorder of white cell production (e.g., aplastic anemia, pernicious anemia), viral infections, malaria, alcoholism, or uncontrolled diabetes. Decreased values may also be due to certain drugs including several antibiotics. Special Consideration: The WBC may vary as much as 2000 per cubic millimeter from day to day as a result of exercise, stress, smoking, digestion or minor infection. Often included in a WBC test is the differential of the white blood cells into five or six types, each of which plays a somewhat different role in the body’s immune response and thus helps in pinpointing a diagnosis. These types are reported as a percentage of the total and also on some lab reports as the absolute number (percent times the actual WBC). Normal range of values will vary from lab to lab and may be higher in children.
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©2005 HealthCheckUSA, Inc. All rights reserved. It is to be used solely by our customers as an aide in understanding the findings of their lab report. Mass reproduction of this Brief or direct copy for purposes related to financial gain without written consent of the editor is prohibited and violators will be vigorously pursued and prosecuted within the law.

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