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Posted by: | Posted on: November 12, 2019

Tylenol in Pregnancy Doubles Risk of Autism


Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2019/11/12/tylenol-during-pregnancy-causing-autism.aspx

Analysis by Dr. Joseph MercolaFact Checked  –  November 12, 2019
tylenol during pregnancy causing autism

STORY AT-A-GLANCE

  • Abnormal hormonal exposures in pregnancy can influence fetal brain development, and research published in 2014 warned acetaminophen is in fact a hormone disruptor
  • According to that 2014 study, use of acetaminophen during pregnancy was associated with a 37% increased risk of the child being diagnosed with hyperkinetic disorder, a severe form of attention deficit hyperactivity disorder (ADHD)
  • A 2019 study found that, compared to children of mothers with the lowest acetaminophen burden, children of mothers with the greatest exposure had a 286% higher risk for ADHD and a 362% higher risk for autism spectrum disorder (ASD) by the time they were about 9 years old
  • Findings published in 2016 revealed use of acetaminophen at 18 and 32 weeks of pregnancy were associated with a 42% higher risk of conduct problems and a 31% higher risk of hyperactivity symptoms in the child
  • Another 2016 investigation found children of both sexes whose mothers used acetaminophen during pregnancy were 41% more likely to present with ADHD symptoms at age 5. Boys were also more likely to have ASD

Many view over-the-counter (OTC) drugs as safe because they don’t require a prescription. Nothing could be further from the truth. Acetaminophen, for example, (also known as paracetamol and sold under the brand name Tylenol among others) is actually one of the more dangerous drugs you can get your hands on.

Despite statistics showing acetaminophen is the leading cause of acute liver failure in the U.S.,1 most people don’t think twice before downing those pills. Acetaminophen is also found in a wide variety of products designed to treat headache, fever and cold symptoms, as well as in prescription pain medications mixed with codeine or hydrocodone.2 And, most households have more than one of the over-the-counter products, which could easily lead to overdosing.

Although it was initially hailed as a safe drug for pain, by 2013 lawsuits were piling up, citing 50,000 trips to the emergency room every year, all due to Tylenol causing liver and kidney failure.3 The grim truth is that as early as 2005 scientists already knew that “severe acetaminophen hepatotoxicity leads to acute liver failure.”4

Not only that, reports also showed that unintentional overdoses accounted for hundreds of suicide attempts, deaths and liver transplants. Along that line, statistics from national database analyses in 20065 showed that acetaminophen accounted for an estimated 56,000 emergency room visits and 26,000 hospitalizations annually. The average annual death toll from acetaminophen overdose was 458.

A number of studies have also linked acetaminophen use during pregnancy with lifelong repercussions for the child, raising their risk of developing conduct disorders, hyperactivity and autism.

Acetaminophen Use Linked to Hyperactivity in Offspring

In 2014, a study in the journal JAMA Pediatrics6 revealed that “Research data suggest that acetaminophen is a hormone disruptor, and abnormal hormonal exposures in pregnancy may influence fetal brain development.” This is a significant concern, considering many pregnant women are likely to reach for an OTC pain reliever at some point during their pregnancy.

According to that 2014 study, use of acetaminophen during pregnancy was associated with a 37% increased risk of their child being diagnosed with hyperkinetic disorder, a severe form of attention deficit hyperactivity disorder (ADHD).

Their children were also 29% more likely to be prescribed ADHD medication by the time they were 7 years old. The strongest associations were observed in mothers who used acetaminophen in more than a single trimester, and the greater the frequency of use, the more likely their child was to experience behavioral problems. As reported by Forbes at the time:7

“Acetaminophen can cross the placenta, making its way to the fetus and its delicate developing nervous system. The drug is a known endocrine (hormone) disrupter, and has previously been linked to undescended testes in male infants.

Since the maternal hormone environment plays a critical role in the development of the fetus, the authors say that it’s ‘possible that acetaminophen may interrupt brain development by interfering with maternal hormones or via neurotoxicity such as the induction of oxidative stress that can cause neuronal death.’”

Similar findings were published in 2016. This study,8 also published in JAMA Pediatrics, found use of acetaminophen at 18 and 32 weeks of pregnancy was associated with a 42% higher risk of conduct problems and a 31% higher risk of hyperactivity symptoms in the child.

When the mother used acetaminophen at 32 weeks of pregnancy, the child also had a 29% higher risk of having emotional problems and a 46% higher risk of “total difficulties.”

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Tylenol in Pregnancy May Double or Triple Risk of Autism

A study9,10,11 published online October 30, 2019, in JAMA Psychiatry further strengthens the link between acetaminophen use and ADHD, while also noting an increased risk for autism spectrum disorder (ASD). According to the authors:12

“Prior studies have raised concern about maternal acetaminophen use during pregnancy and increased risk of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in their children; however, most studies have relied on maternal self-report …

In this cohort study of 996 mother-infant dyads from the Boston Birth Cohort, cord plasma biomarkers of fetal exposure to acetaminophen were associated with significantly increased risk of childhood attention-deficit/hyperactivity disorder and autism spectrum disorder.”

Compared to children of mothers with the lowest acetaminophen burden (first tertile, based on cord plasma biomarkers for acetaminophen), children of those in the second tertile had a 226% higher risk of being diagnosed with ADHD, and a 214% higher risk for an ASD diagnosis by the time they were about 10 years old (average age 9.8 years).

Those with the greatest (third tertile) acetaminophen burden had a 286% higher risk for ADHD and a 362% higher risk for ASD. As noted by the authors,13 their findings “support previous studies regarding the association between prenatal and perinatal acetaminophen exposure and childhood neurodevelopmental risk.”

More Evidence Against Taking Acetaminophen During Pregnancy

In addition to the studies already mentioned, a number of others have also documented this disturbing link between acetaminophen use during pregnancy and neurological problems in the children. Among them:

A 2013 study14 published in the International Journal of Epidemiology found “children exposed to [acetaminophen] for more than 28 days during pregnancy had poorer gross motor development, communication, externalizing behavior, internalizing behavior and higher activity levels” than unexposed children at age 3. Use of ibuprofen was not associated with these neurodevelopmental effects.

A 2016 Spanish investigation15,16 published in the International Journal of Epidemiology found children of both sexes whose mothers used acetaminophen during pregnancy were 41% more likely to present with ADHD symptoms at age 5. Boys were also more likely to have ASD. As noted by the authors:

“Prenatal acetaminophen exposure was associated with a greater number of autism spectrum symptoms in males and showed adverse effects on attention-related outcomes for both genders. These associations seem to be dependent on the frequency of exposure.”

Aside from a higher risk of neurodevelopmental problems, studies have also shown:

Use of acetaminophen during pregnancy may increase your risk of pre-eclampsia and thromboembolic diseases17

Taking the drug for more than four weeks during pregnancy, especially during the first and second trimester, moderately increases the risk of undescended testicles in boys18

Using acetaminophen in the third trimester increases your risk of preterm birth19

Acetaminophen After Birth Also Linked to Autism

The use of acetaminophen after birth may also lead to problems. In fact, some argue the increased risk of autism we see following childhood vaccinations may in fact be due to the inappropriate use of acetaminophen after the shots are given — not the vaccines.20

In my view, it seems irrational to give toxic injections a free pass, but acetaminophen administration could certainly make matters worse. A small preliminary study21 published in 2008 concluded “acetaminophen use after measles-mumps-rubella vaccination was associated with autistic disorder.”

Debunkers of the vaccine-autism connection point to statistics showing that, in the early 1980s, when the autism trend began its precipitously steep incline, vaccines were not only being added to the vaccination schedule, but pediatricians were also told to start using acetaminophen instead of aspirin, as aspirin had been linked to Reye’s syndrome.22

A 2017 study23 even claims “The use of acetaminophen in babies and young children may be much more strongly associated with autism than its use during pregnancy, perhaps because of well-known deficiencies in the metabolic breakdown of pharmaceuticals during early development.”

While parents give babies and infants Tylenol for numerous reasons, one instance in which Tylenol is routinely used is after childhood vaccinations, and according to research24 published in the journal Lancet in 2009, acetaminophen might actually render vaccinations less effective when administered together, which is yet another reason to avoid giving acetaminophen to your baby.

Infants who received acetaminophen right after getting a vaccination experienced lowered immune response, developing significantly fewer antibodies against the disease they were vaccinated against.

The vaccines used in the study were for pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio and rotavirus. The authors concluded that:

“Although febrile reactions significantly decreased, prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced.”

Understand the Risks Associated With Acetaminophen

Pregnant women are not the only ones that need to be careful in their use of this common pain reliever and fever reducer. Acetaminophen overdose is responsible for nearly half of all acute liver failure cases in the U.S.,25 and its use has also been linked to three serious skin reactions; two of which typically require hospitalization and can be fatal.

These problems can happen to anyone. A major problem is that while acetaminophen is considered safe when taken as recommended, the margin between a safe dose and a potentially lethal one is very small.

Provided you have a healthy liver and do not consume more than three alcoholic beverages a day, the recommended oral dose of acetaminophen is up to 1,000 milligrams (mg) every four to six hours, not to exceed 3 grams (3,000 mg) per day.26 As noted by U.S. San Diego Health:27

“To appreciate how easy it is to exceed the safe limit, consider that one extra strength Tylenol tablet contains 500 mg of acetaminophen. Take two tablets at a single dose three times a day and you are at the maximum recommended dose.

If you then inadvertently consume an acetaminophen-containing allergy medication or cold medication in addition, you risk damaging your liver … The key is to be aware of how much acetaminophen you are consuming.”

What’s more, research28 has shown taking just a little more than the recommended dose over the course of several days or weeks (referred to as “staggered overdosing”) can be riskier than taking one large overdose. So, in summary, please be aware that your risk of severe liver injury and/or death increases if you:

  • Take more than one regular strength (325 mg) acetaminophen when combined with a narcotic analgesic like codeine or hydrocodone.
  • Take more than the prescribed dose of an acetaminophen-containing product in a 24-hour period.
  • Take more than one acetaminophen-containing product at the same time — Make sure to read the list of ingredients on any other over-the-counter (OTC) or prescription drug you take in combination.
  • Drink alcohol while taking an acetaminophen product — Research29,30 suggests acetaminophen increases your risk of kidney damage by 123% if taken with alcohol, even if the amount of alcohol is small.

Why You Should Keep NAC in Your Medicine Cabinet

Given their health risks, I generally do not recommend using acetaminophen-containing drugs for minor aches and pains. There are many other ways to address acute and chronic pain that do not involve taking a medication. For a long list of pain-relieving alternatives, please see this previous article.

That said, pain relievers like acetaminophen do have their place. Post-surgical pain, for example, or other severe pain may warrant its temporary use. For those instances, I recommend taking it along with N-acetyl cysteine (NAC), which is the rate-limiting nutrient for the formation of the intracellular antioxidant glutathione.

It is believed that the liver damage acetaminophen causes is largely due to the fact that it can deplete glutathione, an antioxidant compound secreted by your liver in response to toxic exposure. Glutathione also helps protect your cells from free radical damage.

NAC is the standard of care in cases of acetaminophen overdose, approved in 1985 by the FDA as an antidote for acetaminophen toxicity.31 Mortality due to acetaminophen toxicity has been shown to be virtually eliminated when NAC is promptly administered. So, whether you are taking Tylenol in prescription or over-the-counter form, I strongly suggest taking NAC along with it.

Keep in mind, however, that there’s no data showing whether taking NAC would ameliorate the autism or ADHD risk for pregnant women, so if you’re pregnant, I would recommend just avoiding acetaminophen. If you absolutely need an OTC pain reliever, ibuprofen appears to be a safer choice. The same caveat for lack of data goes for infants.

Tips for a More Toxin-Free Pregnancy

I believe it’s imperative to be aware of, and abstain from, as many potential neurotoxins as possible during pregnancy to protect the health of your child. Our environment is saturated with such a wide variety of toxins, and you may not be able to defend yourself against each and every one of them, but you do have a great degree of control within your own immediate household.

The food and drinks you ingest, and the household, personal care and medical products you opt to use during pregnancy can have a distinct impact on your child’s development and long-term health.

ADHD and autism have both skyrocketed in prevalence the past few decades, signaling that something is going terribly wrong. Our environment is becoming overly toxic, and children are paying the price for our chemical-laden lifestyles. OTC drugs like acetaminophen are part of this toxic burden that infants have to contend with.

Avoiding any and all unnecessary drugs is one aspect you have a large degree of control over. Below are several more. Rather than compile an endless list of what you should avoid, it’s far easier to focus on what you should do to lead a healthy lifestyle with as minimal a chemical exposure as possible. This includes:

As much as you’re able, buy and eat organic produce and grass fed, pastured animal foods to reduce your exposure to agricultural chemicals like glyphosate. Steer clear of processed, prepackaged foods of all kinds. This way you automatically avoid pesticides, artificial food additives, dangerous artificial sweeteners, food coloring, MSG and unlabeled genetically engineered ingredients.

Also avoid conventional or farm-raised fish, which are often heavily contaminated with PCBs and mercury. Wild caught Alaskan salmon is one of the very few fish I still recommend eating, as well as small fatty fish like anchovies, sardines, mackerel and herring. If you don’t eat these on a regular basis, consider taking a krill oil supplement to optimize your omega-3 level.

Store your food and beverages in glass rather than plastic, and avoid using plastic wrap and canned foods to avoid exposure to plastic chemicals known to disrupt endocrine function.
Install an appropriate water filter on all your faucets (even those in your shower or bath).
Only use natural cleaning products in your home.
Switch over to natural brands of toiletries such as shampoo, toothpaste, antiperspirants and cosmetics. The Environmental Working Group has a great database32 to help you find safer personal care products. I also offer one of the highest quality organic skin care lines, shampoo and conditioner, and body butter that are completely natural and safe.
Avoid using artificial air fresheners, dryer sheets, fabric softeners or other synthetic fragrances. Relinquish the idea that fragrance equals “clean.” It doesn’t. Clean laundry need not smell like anything at all.
Replace your nonstick pots and pans with ceramic or glass cookware to avoid toxic PFOA chemicals.
When redoing your home and/or shopping for baby items, look for “green” toxin-free alternatives. Avoid plastic toys, especially teething toys, and make sure items like mattresses, car seats and nursing pillows do not contain toxic flame retardant chemicals.
Replace your vinyl shower curtain with one made of fabric, or install a glass shower door. Most all flexible plastics, like shower curtains, contain dangerous plasticizers like phthalates.
Avoid spraying pesticides around your home or insect repellants that contain DEET on your body. There are safe, effective and natural alternatives.
 Sources and References
Posted by: | Posted on: September 26, 2019

Flu Shot Fails to Protect Seniors and May Increase Miscarriages


Reproduced from original article:
articles.mercola.com/sites/articles/archive/2019/09/26/flu-shot-ineffective.aspx

Analysis by Dr. Joseph Mercola  Fact Checked  –  September 26, 2019
flu shot ineffective

STORY AT-A-GLANCE

  • Secondary infections such as pneumonia and other respiratory diseases, as well as sepsis, are included in “influenza death” statistics, and account for a majority of deaths attributed to influenza every year
  • U.S. Centers for Disease Control and Prevention data have repeatedly demonstrated that the flu vaccine does not work for seniors. The 2018/2019 flu vaccines against influenza A and B viruses had an adjusted effectiveness rating of just 12% for those over age 50
  • Studies have also demonstrated that influenza vaccination has little or no impact on mortality among the elderly
  • The flu vaccine is routinely recommended for all pregnant women during any trimester, yet some scientific evidence suggests it could place their pregnancy at risk. Research funded by the CDC found an association between flu vaccination during pregnancy and an eightfold risk of miscarriage
  • Injury following influenza vaccination is now the most compensated claim in the federal Vaccine Injury Compensation Program (VICP). Between January 1, 2006, and December 31, 2017, a total of 3,575 injury claims for flu vaccine were filed

Flu season is creeping up on us again and there are widespread calls to get your annual flu shot, despite the fact that, year after year, this strategy turns out to have an abysmal rate of effectiveness across the board. One group that consistently turns out to draw the short end of the stick when it comes to influenza vaccine failures is the elderly. U.S. Centers for Disease Control and Prevention (CDC) data have repeatedly demonstrated that the flu vaccine does not work for seniors.

Pregnant women are another group that should carefully evaluate the risks and failures of influenza vaccine. The CDC recommends routine flu shots for women during any trimester in every pregnancy, but some scientific evidence suggests it could place their pregnancies at risk.

I’ve written many articles questioning the scientific basis for routine influenza vaccination in general. Here, my focus is the elderly and pregnant women, as there is scientific evidence detailing risks of flu vaccination for both groups.

First, though, I want to remind you of a little-known fact about influenza mortality estimates: Secondary infections such as pneumonia and other respiratory diseases, as well as sepsis,1 are included in “flu death” statistics, and account for a majority of deaths attributed to influenza every year.

Beware of Sepsis

As discussed in a Health magazine article2 published 2018, the symptoms of sepsis can actually mimic influenza symptoms — with disastrous results. In this particular case, a strep infection progressed to sepsis, which presented as influenza and, unfortunately, led to the amputation of the woman’s arms and legs. She says:3

“… if you have a fever that doesn’t go away or your body temperature is abnormally low, you have signs of any type of infection (whether it’s a cold or a UTI) that’s not getting better, you feel confused, or are in a lot of pain, go to your doctor and ask about sepsis.”

To learn more about sepsis and its treatment, see “Recognizing the Signs and Symptoms of Sepsis” and “Sepsis Is a Top Cause of Death in Hospitals.” It’s worth finding out about a relatively new sepsis treatment using intravenous vitamin C, hydrocortisone and thiamine, discussed in these articles.

The treatment has been shown to be extremely effective — far more so than conventional treatments — but many hospitals have yet to make it routinely available, which means it can be difficult to convince them to use it. It’s worth a try, though.

Why Is the Flu Vaccine so Ineffective?

It’s important to remember that the influenza vaccine contains only three or four type A or B vaccine strain influenza viruses, of which there are hundreds. So, even if those vaccine strain viruses are a perfect match for influenza viruses that are circulating in a given flu season, the vaccine does not prevent the majority of other respiratory infections that make people sick and often mistake for influenza unless lab testing is done.4

Twice a year, the World Health Organization issues recommendations on the composition of the upcoming season’s flu vaccines. For the 2019/2020 season, trivalent vaccines distributed in the U.S. will contain:5,6,7

  • A/Brisbane/02/2018 (H1N1)pdm09-like virus
  • A/Kansas/14/2017 (H3N2)-like virus
  • B/Colorado/06/2017-like (Victoria lineage) virus

Quadrivalent vaccines will contain the three above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus. The selected strains for this year are anticipated to improve coverage. In Australia, where the flu season got an early start in the Southern Hemisphere, health officials told people to get vaccinated because it could be an unusually severe season.8 The predominant influenza viruses circulating in Australia this year have been H3N2 influenza A virus followed by influenza B virus.9

In the U.S., health officials have said that the selection of influenza viruses for inclusion in the vaccine this year occurred later than usual. There are reports that flu vaccine production and shipments have been delayed and there will a shorter window of opportunity to get vaccinated.10

A study11 published in 2018 sheds some much-needed light on unvaccinated individuals at risk for influenza and how as many as half of unvaccinated people infected with influenza do not know they have it. Researchers found that “approximately 1 in 5 unvaccinated children and 1 in 10 unvaccinated adults were estimated to be infected by seasonal influenza annually, with rates of symptomatic influenza roughly half of these estimates.”

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Flu Vaccine Effectiveness Has Always Been Low

Historically, regardless of how well-matched the vaccine is to circulating strains, your chances of getting influenza after vaccination are still greater than 50/50 in any given year. According to CDC data updated September 10, 2019,12 the 2018/2019 flu vaccine (all vaccine types) against influenza A or B viruses had an adjusted effectiveness rating of:

29% for all ages
49% for children aged 6 months through 8 years
6% for children ages 9 through 17
25% for adults between the ages of 18 and 49
12% for those over 50
12% for those over 65

Ironically, despite offering no protection for more than two-thirds of the population, health officials in February touted higher numbers, calling them a great success, as the numbers they had at that time outperformed the 2017/2018 vaccine. Obviously, as the Southern Hemisphere’s season wore on, the numbers wore down, and they’re just as abysmal, if not more so, than other years.13

The 2017/2018 seasonal influenza vaccine’s adjusted overall effectiveness for the U.S. was just 36% against influenza A and influenza B virus infection.14,15 To put this into context, gargling with tea has been shown to lower your relative risk of the flu by 30%.16

Between 2005 and 2015, the flu vaccine’s adjusted overall effectiveness was less than 50% more than half the time — with a low of only 10% in the 2004/2005 season.17,18

Vaccinated Individuals Pose a Hidden Threat to Public Health

It’s also important to realize that you can get vaccinated, show few or no symptoms of infection, and still shed and transmit influenza to other people.19,20 This scientific fact flies in the face of statements claiming that vaccination is a “social responsibility” that “protects others around you, including family, friends, co-workers and neighbors.”21

In reality, after vaccination, you may actually become a contagious silent carrier of disease. A person with influenza who fully expresses symptoms of fever, body aches, cough and other signs of respiratory illness would likely stay at home. However, a vaccinated individual, who is silently contagious, would go to work and into stores and other public places and be unaware they are spreading infection.

This is an especially important fact for vaccinated health care workers, who move freely among patients in hospitals and other medical facilities because everyone assumes vaccinated medical personnel are “immune” to influenza if they get a flu shot every year.

A study22 published in the journal PNAS January 18, 2018, showed that people who receive the seasonal flu shot and then contract influenza excrete infectious influenza viruses through their breath.

What’s more, those vaccinated two seasons in a row have a greater viral load of shedding influenza A viruses. According to the authors, “We observed 6.3 times more aerosol shedding among cases with vaccination in the current and previous season compared with having no vaccination in those two seasons.”

They also note that other studies suggest annual flu vaccination leads to reduced protection against influenza, which means each vaccination is likely to make you progressively more prone to getting sick.

A 2014 paper23 also reveals how priming your immune system with influenza vaccine can make you more susceptible to infection from other viral and bacterial pathogens. This phenomenon is an effect inherent in what’s known as “heterologous immunity.”

Year After Year, Flu Vaccine Proves Useless for Seniors

As mentioned, the 2018/2019 flu vaccine had an adjusted effectiveness rating of just 12% for those ages 50 and above,24 but the full range was between a negative 12% to a positive 31% for ages 50 to 64 and a negative 29 to 41 in those over age 65. That means that for some people, vaccination actually made them more susceptible to infection. Unfortunately, the 9- to 17-year-old group also had a negative confidence interval.

For infections caused by the A(H3N12) virus, the statistics were even more worrisome, with a mere overall adjusted effectiveness of 9% for all ages. For A(H1N1) the numbers were better at 44% — but it’s worth noting that the CDC chose to lump all ages together in that report, rather than breaking them down by age (something they had done earlier in the year, and which they had done for all past years). For example:

  • In 2017/2018,25,26 the adjusted influenza vaccine effectiveness for all vaccine types against influenza A viruses for people aged 50 through 64 was 20% (range: -5% to 39%); for those over the age of 65 it was 11% (range: -8% to 38%)
  • In 2016/2017,27 the adjusted effectiveness for all vaccine types against influenza A or B viruses for those aged 50 through 64 was 40% (range: 24% to 53%), and those over 65 was 20% (range: -11% to 43%). This despite the fact that the vaccine for the 2016/2017 season was well-matched to the viruses in circulation28

Studies29,30 have also demonstrated that influenza vaccination has no impact on mortality among the elderly. As noted in one such study,31 “Because fewer than 10 percent of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit.”

Research32 published in 2006 analyzed influenza-related mortality among the elderly population over age 65 in Italy, where flu vaccination coverage between 1970 and 2001 had significantly increased. Here too, investigators found no corresponding decline in deaths. According to the authors:

“These findings suggest that either the vaccine failed to protect the elderly against mortality (possibly due to immune senescence), and/or the vaccination efforts did not adequately target the frailest elderly. As in the U.S., our study challenges current strategies to best protect the elderly against mortality, warranting the need for better controlled trials with alternative vaccination strategies.

Another 2006 study,33 which followed 72,527 seniors for eight years, showed that, even though seniors vaccinated against influenza had a 44% reduced risk of dying during flu season compared to unvaccinated seniors, those who were vaccinated were also 61% less like to die before the flu season ever started — a finding attributed to the “healthy user” effect.

According to the authors, “the magnitude of the bias demonstrated by the associations before the influenza season was sufficient to account entirely for the associations observed during influenza season.” In other words, the vaccine played no role whatsoever in reducing the risk of death during flu season.

Research trying to ascertain whether flu vaccination has any impact on hospitalization rates among the elderly has found it difficult to draw any conclusions due to rampant bias. As noted in a 2019 study34 in the journal Vaccine:

“… 22 studies were included in the systematic review. Overall, two studies (9%) were deemed at moderate risk of bias, thirteen (59%) at serious risk of bias and seven (32%) at critical risk of bias.

For outpatient visits, we found modest evidence of protection by the influenza vaccine. For all-cause hospitalization outcomes, we found a wide range of results, mostly deemed at serious risk of bias.

The included studies suggested that the vaccine may protect older adults against influenza hospitalizations and cardiovascular events. No article meeting our inclusion criteria explored the use of antibiotics and ILI hospitalizations. The high heterogeneity between studies hindered the aggregation of data into a meta-analysis.”

Cell-Based Flu Vaccine No Better Than Egg-Based

The “new and improved” flu shot, Flucelvax — a cell-based35 rather than egg-based vaccine — introduced during the 2017-2018 flu season, has also demonstrated disappointing results. Research by the U.S. Food and Drug Administration found it protected just 26.5% of those over the age of 65.36

A study37 published September 2019, “Comparison of Vaccine Effectiveness Against Influenza Hospitalization of Cell-Based and Egg-Based Influenza Vaccines, 2017-2018” also concluded that:

“For any influenza, the adjusted relative VE [vaccine effectiveness] of cell-based vaccine versus egg-based vaccines was 43% for patients ages < 65 years and 6% for patients ages ≥ 65 years.

For influenza A(H3N2), the adjusted relative VE was 61% for patients ages < 65 years and −4% for patients ages ≥ 65 years. Statistically significant protection against influenza hospitalization of cell-based vaccine compared to egg-based vaccines was not observed …”

Is Flu Vaccine Safe for Pregnant Women?

Historically, pregnant women have been discouraged from taking drugs and vaccines because there’s very little scientific data evaluating risks for the pregnant woman or the growing fetus. Including pregnant women in clinical trials has been considered unethical because there are unknown risks for both mother and child.

For better or worse, that is changing. In 2018, the FDA issued nonbinding recommendations38 for industry detailing when and how pregnant women can be enrolled in clinical trials for drugs and therapies.

Coincidentally, the increased push for women to get flu shots during any trimester in every pregnancy seems to coincide with an amendment to the 1986 National Childhood Vaccine Injury Act that was included in the 21st Century Cures Act passed by Congress at the end of 2016.

The amendment gives a liability shield to drug companies producing CDC-recommended vaccines for pregnant women so they can’t be sued if a pregnant woman or her child developing in the womb born alive suffers injury from maternal vaccinations.39

As noted by Barbara Loe Fisher, co-founder and president of the National Vaccine Information Center in a public statement given at a hearing September 17, 2018:40

“This is a stunning expansion of vaccine product liability protection for the pharmaceutical industry in a 1986 tort reform Act that created a federal compensation program option for children injured by government recommended and mandated vaccines that was never intended to cover adults or be an exclusive remedy.”

Despite the lack of safety data when it comes to maternal vaccination,41 the CDC now urges all pregnant women to get vaccinated against the flu. In a 2018 article,42 CNN quotes Dr. Laura E. Riley, professor and chair of the department of obstetrics and gynecology at Weill Cornell Medicine, saying “The flu vaccine is safe and effective for both pregnant women and their fetuses” and can be given during any trimester.

A definitive statement like that deserves strong supporting evidence, but not only is safety data for pregnant women sorely lacking, some of the data published in the medical literature suggests maternal vaccination may actually be deeply problematic.

Flu Vaccination Linked to Eightfold Risk of Miscarriage

Importantly, research43,44 funded by the CDC itself linked flu vaccination during early pregnancy to an eightfold risk of miscarriage. In all, 485 pregnant women aged 18 to 44 who had a miscarriage during the flu seasons of 2010/2011 and 2011/2012 were compared to 485 pregnant women who carried to term.

Women who had received an inactivated 2009 pandemic H1N1-containing flu shot the previous year were more likely to suffer miscarriage (spontaneous abortion) within 28 days of receiving another pH1N1-containing flu shot during pregnancy.

While most of the miscarriages occurred during the first trimester, several also took place in the second trimester.45,46,47 The median fetal term at the time of miscarriage was seven weeks.

Of the 485 women who miscarried, 17 had been vaccinated twice in a row — once in the 28 days prior to miscarriage and once in the previous year. For comparison, of the 485 women who had normal pregnancies, only four had been vaccinated two years in a row. CDC adviser for vaccines Amanda Cohn told The Washington Post:48

“I think it’s really important for women to understand that this is a possible link, and it is a possible link that needs to be studied and needs to be looked at over more [flu] seasons. We need to understand if it’s the flu vaccine, or is this a group of women [who received flu vaccines] who were also more likely to have miscarriages.”

Contradictory Findings Proclaimed ‘Unequivocal’ Evidence

The same researchers have now completed a second study and, this time, they found no link between flu vaccination and miscarriage. A quote by Dr. Edward Belongia, head of the Center for Clinical Epidemiology and Population Health at Wisconsin’s Marshfield Clinic, in STAT news reads:49 “For women right now who are wondering if it’s safe to get a vaccine in early pregnancy, we can say unequivocally, ‘Yes, it is safe.'”

The data, presented at a February 2019 Advisory Committee on Immunization Practice meeting, has yet to be published so I cannot give any details on the findings as of yet. I’d like to point out the obvious, though.

When the 2017 study came out, detractors were quick to point out that you can’t draw conclusions based on a single study. Yet now, they’re claiming to have “unequivocally” proven safety — based on a single study. In my view, the issue is still wide open for discussion and contemplation. Far more research needs to be done before a claim of safety can be made for women receiving influenza vaccine during pregnancy.

Categorical claims of safety cannot be made for vaccinating infants younger than 6 months against influenza, either.

The 2019 scientific review,50 “Influenza Vaccination: Effectiveness, Indications, and Limits in the Pediatric Population,” published in the journal Frontiers in Pediatrics, points out that “questions and limits about influenza vaccine in pediatric population remain open,” and that “vaccine effectiveness in children is variable and suboptimal, with reported differences according to vaccine types, seasons, and child age.” It also states that “there is no influenza vaccine that directly protects infants <6 months of age.”

Questions Abound About Vaccine Safety for Pregnant Women

In the 2013 article, “Vaccination During Pregnancy: Is it Safe?”51 Loe Fisher lists 10 vaccine facts pertaining to the lack of evidence of safety in pregnant women, including the following:

  1. Drug companies did not test the safety and effectiveness of giving influenza vaccine to pregnant women before the vaccines were licensed in the U.S.52,53
  2. Data on inflammatory and other biological responses to vaccination during pregnancy that could affect pregnancy and birth outcomes are still lacking.54 For example, it’s still unknown whether the influenza vaccine can cause fetal harm or affect your reproductive capacity,55 which is why the vaccine manufacturer product inserts state that the influenza vaccine should be given to a pregnant woman only if it’s “clearly needed.”
  3. The biological mechanisms of how maternal vaccination affects the immune and neurological systems of mother and child are not known. Loe Fisher points out, “There are no published biological mechanism studies that assess pre-vaccination health status and measure changes in brain and immune function and chromosomal integrity after vaccination of pregnant women or their babies developing in the womb.”
  4. There are very few studies comparing health outcomes between pregnant women and their children who receive the flu vaccine and those who do not.

Flu Vaccine Has Thousands of Vaccine Injury Filings

Importantly, injury following influenza vaccination is the most compensated claim in the federal Vaccine Injury Compensation Program (VICP). Between January 1, 2006, and December 31, 2017, a total of 3,575 injury claims for flu vaccine were filed, 3,057 of which were compensated.56 Being one of the riskiest vaccines, based on VICP injury filings and awards, is it really wise to proclaim the flu vaccine is safe for all pregnant women at all times?

Influenza vaccine package inserts57,58,59 will also inform you that flu vaccine safety and effectiveness have not been established in pregnant or breastfeeding women. This means there is a lack of scientific evidence demonstrating conclusively that pregnant women will benefit from flu vaccination or that getting vaccinated during pregnancy is, in fact, safe.

If safety and effectiveness have not been scientifically established through methodologically sound and rigorously controlled, replicated studies, the issue is still open for debate, and that’s certainly true when it comes to vaccinating pregnant women.

Sanofi Pasteur’s patient information sheet60 for Fluzone quadrivalent vaccine states that “Sanofi Pasteur Inc. is collecting information on pregnancy outcomes and the health of newborns following vaccination with Fluzone Quadrivalent during pregnancy.”

The American College of Obstetricians and Gynecologists also tracks vaccine safety for pregnant women after the fact, while claiming it’s perfectly safe to receive the flu vaccine during pregnancy.61 The sad reality is that pregnant women who are given influenza vaccinations during any trimester during every pregnancy are basically participating in an uncontrolled experiment. They just don’t know it.

Vaccinating During Pregnancy Is a Risky Proposition

Aside from the 2017 study linking flu vaccination to miscarriage, research has shown that stimulating a woman’s immune system — which is what vaccination does and must do to stimulate production of antibodies and artificial immunity — during midterm and later-term pregnancy significantly increases the risk that her baby will develop autism62 during childhood, and/or schizophrenia during the teenage years or early adulthood.63

Strong inflammatory responses during pregnancy may also increase the risk of seizures in the baby, and later, as an adult.64 In fact, a number of neurodevelopmental and behavioral problems can occur in babies born to women immunologically stimulated during pregnancy.65,66,67

Overall, given the uncertainty about how flu vaccination affects health in the short and long term, and the absolute unknowns about how it may affect the future health of the baby, it seems as reasonable to avoid vaccination during pregnancy as it is to avoid alcohol, smoking and exposure to other toxins.

As noted by Jeremy R. Hammond in his May 14, 2019, article, “The CDC’s Criminal Recommendation for a Flu Shot During Pregnancy,”68 the CDC relies on retrospective observational studies for its recommendation. The problem with that is that retrospective observational studies are designed to test a hypothesis. They’re not designed to prove or disprove causation and, in fact, cannot do that.

So, a finding of “no association” in an observational study does not mean that a causal relationship is nonexistent. Observational studies also make it difficult for researchers to detect unexpected harms. If they’re not specifically looking for an outcome, it likely will not show in the data.

It’s a rather long and detailed article, but well worth reading. In it, Hammond points out the hypocrisy of relying on observational data for vaccine safety, saying:69

“[W]hen Aaron E. Carroll in the New York Times advocated the CDC’s flu shot recommendations, he was telling pregnant women, too, to get vaccinated.

He was, in other words, parroting the CDC’s implicit message that we can trust that observational studies are methodologically robust enough to rule out the possibility, with a high degree of confidence, that vaccination could cause harm to the expectant mother or her child.

Yet just a few months earlier, Carroll had reassured the public that observational studies finding a link between alcohol consumption and cancer aren’t determinative and suggested that more randomized controlled trials are needed to establish what harms and benefits are associated with drinking!

As he advised Times readers in that case, ‘Don’t give too much weight to observational data’ … Why should we forego our skepticism when it comes to the lives and health of entire future generations of children? …

Carroll’s credulous acceptance of the observational studies that the CDC relies upon to support its claims is another good example of the kind of institutionalized cognitive dissonance that exists when it comes to the practice of vaccination. It has become a religion, and we are supposed to believe in the safety and effectiveness of vaccines as a matter of faith …

When it comes to vaccines, we are not supposed to concern ourselves with the methodological weaknesses of the kinds of studies the CDC relies on to support its flu shot recommendation for pregnant women.

We are not supposed to notice that the CDC’s statement that ‘there’s a lot of evidence’ that it’s safe to vaccinate pregnant women also implies that there’s at least some evidence that it is not …

[I]f pharmaceutical companies made the same claims that the CDC makes about the safety of vaccinating pregnant women, they could be sued for fraud.”

References:

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3 Health October 2, 2018 https://www.health.com/cold-flu-sinus/sepsis-left-me-an-amputee
4 Cochrane.org http://www.cochrane.org/CD001269/ARI_vaccines-prevent-influenza-healthy-adults
5 Precisionvaccinations.com 2019-2020 Recommendations
https://www.precisionvaccinations.com/who-vaccine-recommendations-are-used-pharmaceutical-companies-develop-produce-and-license-influenza
6 CDC.gov Upcoming 2019/2020 Flu Season https://www.cdc.gov/flu/season/flu-season-2019-2020.htm
7 Pharmacy Times May 2, 2019 https://www.pharmacytimes.com/contributor/marilyn-bulloch-pharmd-bcps/2019/05/changes-in-influenza-vaccine-may-improve-coverage
8 7 News May 27, 2019 https://7news.com.au/news/health/flu-deaths-2019-australia-three-influenza-strains-causing-deadly-flu-season-c-135163
9 VaxBeforeTravel. Aug. 12, 2019. https://www.vaxbeforetravel.com/australianpharmacists-may-have-reduced-influenza-season-impact-2019
10 WFLA.com July 23, 2019 https://www.wfla.com/video/doctors-warn-of-delayed-vaccine-shipments-ahead-of-flu-season/
11 Vaccine May 311, 2018; 36(23): 3199-3207
https://www.sciencedirect.com/science/article/pii/S0264410X18305607?via%3Dihub
12 CDC.gov 2018-2019 Vaccine Effectiveness https://www.cdc.gov/flu/vaccines-work/2018-2019.html
13 US News February 14, 2019 https://www.usnews.com/news/healthnews/articles/2019-02-14/flu-shot-much-more-effective-this-year-cdc-says
14 CDC.gov MMWR February 16, 2018; 67(6): 180-185
https://www.cdc.gov/mmwr/volumes/67/wr/mm6706a2.htm?s_cid=mm6706a2_e
15 The Lancet April 6, 2016
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16 BMC Public Health. 2016; 16: 396, Results
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866433/#__ffn_sectitle
17 CDC, December 21, 2015 Influenza Vaccine Effectiveness: How Well Does the Flu Vaccine Work?
18 CDC, February 14, 2019
https://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm
19 Clinical Infectious Diseases December 22, 2016; 64(6): 736-742
https://academic.oup.com/cid/article/64/6/736/2733100
20 PLOS One December 11, 2012, DOI: 10.1371/journal.pone.0051653
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051653
21 CNN September 27, 2018 https://www.cnn.com/2018/09/26/health/flu-deaths-2017-2018-cdc-bn/index.html
22 PNAS January 18, 2018; 115(5): 1081-108
http://www.pnas.org/content/early/2018/01/17/1716561115
23 Journal of Leukocyte Biology 2014 Mar; 95(3): 405–416 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923083/
24 CDC.gov 2018-2019 Vaccine Effectiveness https://www.cdc.gov/flu/vaccines-work/2018-2019.html
25 CDC.gov Influenza VE Tables for 2017-2018 https://www.cdc.gov/flu/vaccines-work/2017-2018.html
26 MD Edge February 15, 2018
https://www.mdedge.com/jcomjournal/article/158749/influenza/mmwr-current-flu-vaccine-does-not-protect-elderly
27 CDC.gov, Influenza VE Tables for 2016/2017
https://www.cdc.gov/flu/vaccines-work/2016-2017.html
28 Medicalxpress June 21, 2017 https://medicalxpress.com/news/2017-06-fluvaccine-ineffective-people-older.html
29 Jama Internal Medicine 2005;165(3):265-272
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486407
30 Vaccine 2006 Oct 30;24(42-43):6468-75 https://www.ncbi.nlm.nih.gov/pubmed/16876293
31 Jama Internal Medicine 2005;165(3):265-272
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486407
32 Vaccine 2006 Oct 30;24(42-43):6468-75 https://www.ncbi.nlm.nih.gov/pubmed/16876293
33 International Journal of Epidemiology April 1, 2006; 35(2): 337-344
https://academic.oup.com/ije/article/35/2/337/694702/Evidence-of-bias-in-estimates-of-influenza-vaccine
34 Vaccine May 27, 2019; 37(24): 3179-3189
https://www.sciencedirect.com/science/article/pii/S0264410X19305250
35 CDC.gov Cell-Based Flu Vaccine https://www.cdc.gov/flu/prevent/cell-based.htm
36 U.S. News & World Report, June 20, 2018
https://www.usnews.com/news/news/articles/2018-06-20/new-flu-vaccine-works-a-little-better-than-traditional-shot
37 Vaccine September 16, 2019; 37(39): 5807-5811
https://www.sciencedirect.com/science/article/pii/S0264410X19310746
38 FDA.gov, Pregnant Women: Scientific and Ethical Considerations for Inclusion in Clinical Trials, Guidance for Industry (DRAFT April 2018) (PDF)
https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM603873.pdf
39 National Vaccine Information Center September 18, 2018
https://www.nvic.org/NVIC-Vaccine-News/September-2018/nvicp-add-vaccines-pregnant-women-injury-table.aspx

40 National Vaccine Information Center September 18, 2018
https://www.nvic.org/NVIC-Vaccine-News/September-2018/nvicp-add-vaccines-pregnant-women-injury-table.aspx
41 Vaccine 2003; 21(24): 3487-3491
http://www.sciencedirect.com/science/article/pii/S0264410X03003578
42 CNN September 27, 2018 https://www.cnn.com/2018/09/26/health/flu-deaths-2017–2018-cdc-bn/index.html
43 Vaccine September 25, 2017; 35(40): 5314-5322
http://www.sciencedirect.com/science/article/pii/S0264410X17308666
44 Fortune September 13, 2017 http://fortune.com/2017/09/13/flu-vaccine-miscarriage-link-study/
45 Vaccine September 25, 2017; 35(40): 5314-5322
https://www.sciencedirect.com/science/article/pii/S0264410X17308666
46 AAFP September 20, 2017 https://www.aafp.org/news/health-of-thepublic/20170920flumiscarry.html
47 CDC.gov September 13, 2017
https://www.cdc.gov/flu/professionals/vaccination/vaccination-possible-safety-signal.html
48 Washington Post September 13, 2017
https://www.washingtonpost.com/news/to-your-health/wp/2017/09/13/researchers-find-hint-of-a-link-between-flu-vaccine-and-miscarriage/
49 STAT News February 27, 2019 https://www.statnews.com/2019/02/27/new-study-finds-no-link-between-flu-shots-and-miscarriages-allaying-fears/
50 Frontiers in Pediatrics 2019; 7: 317 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682587/
51 NVIC.org November 9, 2013 http://www.nvic.org/NVIC-VaccineNews/November-2013/Vaccination-During-Pregnancy–Is-It-Safe-.aspx
52 Vaccine 2003; 21(24): 3487-3491
http://www.sciencedirect.com/science/article/pii/S0264410X03003578
53 CDC. MMWR 2011; 60(41): 1424-1426
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a4.htm
54 Vaccine 2011; 29(48): 8982-8987
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3204610/
55 NVIC.org. Influenza Vaccine Package Inserts: Important Information from Manufacturers http://www.nvic.org/vaccines-and-diseases/Influenza/Influenza-Vaccine-Package-Inserts.aspx
56 HRSA.gov, VICP Adjudication Statistics, Updated September 1, 2019 (PDF)
https://www.hrsa.gov/sites/default/files/hrsa/vaccine-compensation/data/data-statistics-september-2019.pdf
57 Fluzone Package Insert https://www.fda.gov/media/99172/download
58 Fluarix Package Insert https://www.fda.gov/media/84804/download
59 Afluria Package Insert http://labeling.seqirus.com/PI/US/Afluria/EN/Afluria-Prescribing-Information-TIV.pdf

60 Sanofi Pasteur Patient Information Sheet Fluzone Quadrivalent Vaccine (PDF)
https://www.vaccineshoppe.com/image.cfm?doc_id=13724&image_type=pis_pdf
61 American College of Obstetricians and Gynecologists September 13, 2017
https://www.acog.org/About-ACOG/News-Room/Statements/2017/It-is-Safe-to-Receive-Flu-Shot-During-Pregnancy
62 Excessive Vaccination and Autism, Russel Blaylock MD (PDF)
http://beyondhealth.com/media/wysiwyg/kadro/articles/ExcessiveHungerandAutis
m.pdf
63 Journal of Neuroscience 2007; 27: 10695-10702
https://www.ncbi.nlm.nih.gov/pubmed/17913903
64 Journal of Neuroscience 2008; 28: 6904-6913
http://www.jneurosci.org/content/28/27/6904
65 Brain Behavior and Immunity 2001; 15: 411-420
https://www.ncbi.nlm.nih.gov/pubmed/11782107
66 Biological Psychiatry 2006; 59: 546-554
https://www.ncbi.nlm.nih.gov/pubmed/16256957
67 Brain Behavior and Immunology 2006; 20: 378-388
https://www.ncbi.nlm.nih.gov/pubmed/16378711
68 Jeremyhammond.com May 14, 2019
https://www.jeremyrhammond.com/2019/05/14/the-cdcs-criminal-recommendation-for-a-flu-shot-during-pregnancy/

The above list at:
mercola.fileburst.com/PDF/References/flu-shot-ineffective-ref.pdf

Posted by: | Posted on: August 9, 2019

Blood Tests – How to read the results

By Brenton Wight – LeanMachine, Health Researcher, updated 29th November 2019

Blood Tests – They May Save Your Life!

Blood tests should be carried out with your annual checkup, or any time you have a medical condition

Urine tests are also common, but many are inaccurate, because they only tell us what has left the body, not what is currently available in the body to feed our cells and keep us in good health.
Urine tests are included here where appropriate and where the results can be useful.
Important:
ALWAYS get a printed copy of your tests. The Doctor cannot refuse as the results belong to you.
Unfortunately, Doctors often only look at results outside the “normal range” and disregard everything else.
There are several problems here.

  • There can be potential problems buried within the “normal range”
  • The “normal range” is an average range for a person of the same age and sex as you, not accounting for weight, height, body fat, muscle mass, and general physical condition
  • The “normal range” given does not indicate if the low end, middle or high end of the range is optimal
  • The “normal range” does not always inform you of changes over time within the range which may indicate a better or worse diet, health or impending sickness, etc
  • The “normal range” includes a lot of sick people, skewing the results

For example, the “normal range” for vitamin D3 is 60 to 160 nmol/litre for most Australian labs (some labs now say 75), but the OPTIMAL range is 125 to 175 nmol/litre, with the preference at the high end of the range.
When the results come in at 61, the lab says you are fine, the doc says you are fine, but your immune system is nowhere near the optimum level!
Another example is TSH (Thyroid Stimulating Hormone). The “normal range” is 1.0 to 4.0 but anything over 2.0 is certainly undesirable, and may indicate a hypothyroid condition, going un-diagnosed because the lab and the doc both agree “you are fine”.

Reference Ranges

Some labs indicate “Reference Range”, other labs may indicate “Normal Range”, “Reference Intervals”, “Desirable Range”, “Healthy Range”, Target Range”, “Average Range”, “Suggested Range”, “Optimal Range” which all sound similar, but actual values may vary.
Reference ranges are calculated by the lab as what 95% of the “normal” population conform to (2 standard deviations for you mathematicians).
However, in the 95% of the population who are considered “normal”, we have some sick, healthy, athletic, frail, obese, slim, old, young people of different ethnic backgrounds, occupations, environments, exposure to toxins, which can skew the test results, along with many other factors such as male or female.
Just because we fit into the reference range, it does not mean that we are in the best physical condition.
And for the 5% (or 1 in 20 people) who are outside this range, but still considered “normal” their results are questionable, whether they are at the healthy or unhealthy end of the reference range, which can be a high or a low number, depending on the test.
In some tests, a small margin over or under the reference value can indicate a problem, and in other tests, we can be several hundred times the reference range before we have a serious condition.
The labs will do their best job to calculate the reference range for our age and sex, sometimes weight, sometimes our medical condition, but that is all.
Every lab uses their own terminology, their own test equipment and their own numbers, so typical results may vary.
USA labs often use different units for measurement compared to Australian and other countries, so we must always look at the units as well as the numbers.
Many labs are now trying to standardise in SI (Standard International) units.
It is a good idea to use the same lab each time so that any changing numbers over time can be used as clues to various medical conditions or changes in health.
Many labs who upgrade their equipment and/or software will give two sets of results, pertaining to old and new systems.

Some Conditions Diagnosed by a Blood Test

Malnutrition

Even though we eat much more than our ancestors, modern foods are often devoid of nutrients due to repetitive farming practices, over-processing, over-heating, and the addition of toxic chemicals, trans fats, sugars, etc which all contribute to bad health and a reduced ability for the body to absorb nutrients from food.
Many prescription medications, especially antacids and PPI’s (Proton Pump Inhibitors like Nexium) make this problem even worse by REDUCING stomach acid.
The body NEEDS stomach acid to absorb nutrients AND to make vitamin B12, an important part of the digestion process.
We can have a full stomach, but be starved of nutrients without adequate stomach acid.
People with lap-band or similar surgery, or who have part of the stomach or intestines removed due to disease or cancer, or who have damaged gut bacteria from antibiotics or other prescription medication,
or who have taken antacids or PPI (Proton Pump Inhibitors), or who have a diet poor in nutrition, will have poor absorption of vitamins, minerals, amino acids, etc and can easily suffer from malnutrition.
Malnutrition itself can skew the results of other blood tests, and doctors do not always take this into account, as most assume malnutrition cannot exist in modern society.

Cardiovascular Disease

High LDL cholesterol with low HDL cholesterol, combined with high triglycerides is a warning sign of future heart attack or stroke, and diet must be improved to reverse this condition.
These tests are not part of a normal blood workup so we should ask the doctor for a “lipid study”.

Tumours or Cancer

Cancer tests are described under the Cancer Tests heading near the bottom.

Abnormal White Blood Cell Count and/or Platelet Counts

May indicate Leukemia, with early treatment promoting better recovery.

Diabetes

Diabetes, or even pre-diabetes, can be caught early with a simple blood glucose test.
This condition is easily controlled with some very basic changes to the diet, combined with regular exercise.
Left unchecked, diabetes can lead to blindness, amputations, heart attack, stroke or death.

Allergies or Parasites

Blood tests can reveal these problems, and simple steps are required to correct these conditions.

Infections

Infections can spread, causing a lot of damage, but are easily treated if diagnosed with a blood test.

Anemia

Can be caused by many things including internal bleeding, kidney disease, malnutrition, vegan diet, etc but can usually be simply treated.

Thyroid Problems

The thyroid controls many other hormones in the body, but problems can be found easily with a blood test.
This test must be asked for, as it is not included in a typical blood workup.

Symptoms requiring a blood test

  • Unexplained Tiredness
  • Unexplained weight gain
  • Unexplained weight loss
  • Fever
  • Unexplained pain
  • Changes in bowel habits
  • A long time since the previous test

Preparing for the test

Your Doctor will arrange the test. Ensure that you ask the following:

  • Do I have to fast?
  • Can I drink water?
  • Do I continue my prescription medication?
  • Do I continue my supplements, vitamins, minerals?
  • If I am on blood-thinning medication, what precautions are required?
  • Have I donated blood recently, or can I soon?
  • Please give me a printed copy for my opn records when the results are available.

If the test is a fasting test, arrange a time early in the morning for the test so you can follow up with a nourishing breakfast afterwards.
Do not drink alcohol for 24 hours before the test.
Avoid fatty foods at the last meal before the test.
If all of the results are “within the normal range” it does not mean you can now forget everything.
Compare all results with previous tests, and keep results to compare with the next tests.
If you still have some unexplained condition, there may be repeated tests, new tests, ultrasound, x-rays, CT, MRI or other tests required.
Even if you are feeling fine, look up your previous test results.
If you do not have these results, ask the Doctor – previous records should be on their database, as they are generally e-mailed from the lab.
Compare the results line by line to check if any levels are getting better or worse. Some results will give a higher or lower number,
but check details below on each individual test to work out if this means getting better or getting worse.
Discuss all results with your Doctor, and if you cannot get useful answers, find another Doctor!

Some of the many different Blood Test Measurements and abbreviations

Some Australian (SI), some USA measurements.

  • cmm – cells per cubic millimeter
  • g/L – grams per liter
  • g/dL – grams per deciliter (1/10 of grams per liter)
  • IU/L – international units per liter
  • mEq/L – milliequivalent per liter
  • mg/dL – milligrams per deciliter
  • mL – milliliter
  • fL – femtoliter, 10-15 Liter, or one thousand trillionth (one quadrillionth) of one liter.
  • mmol/L – millimoles per liter
  • ng/mL – nanograms per milliliter
  • pg/mL – picograms (one-trillionth of a gram) per mL (milli-litre)

The standard CBE (Complete Blood Exam), also called CBC (Complete Blood Count) or FBE (Full Blood Exam)

This is the most common test ordered by the Doctor – by no means complete, but can isolate many common problems.
This test determines red blood cells, various white blood cells, and platelets in the blood.
Do not consider these figures absolute, as different labs and different countries and different ages and sexes of patients have different ranges.
Not all labs do all of the tests.
Not all doctors ask for all of the tests.
Many of the tests are for specific diagnosis or monitoring of some disease or condition.

The Red Blood Cell Test Group

Hb or Hgb (Haemoglobin)

Normal values for adult males: 130 to 170 g/L (13.0 to 17.0 g/dL), adult females: 120 to 150g/L (12.0 to 16.0 g/dL)
OPTIMUM values for adult males: 140 to 150 g/L (14.0 to 15.0 g/dL, adult females: 135 to 145g/L (13.5 to 14.5 g/dL)

Adult males after middle age: 124 to 149 g/L (12.4 to 14.9 g/dL), adult females after middle age: 117 to 138 g/L (11.7 to 13.8 g/dL)
This is the iron-containing component of red blood cells which carries oxygen from the lungs to every part of the body, and gives the red cells their bright red colour.
Low Haemoglobin levels often indicate Anaemia.
Hemoglobin must be evaluated with HCT (hematocrit), RBC and MCV to determine if there is fact anemia and the type of anemia.
Low Haemoglobin can be caused by:

  • Low production of red blood cells in the bone marrow
  • Low iron intake
  • Low folate and/or vitamin B12
  • Internal or external bleeding
  • Blood cell destruction
  • Chronic illness
  • Low testosterone
  • Vegan, vegetarian or low-carbohydrate diet

High Haemoglobin can be caused by:

  • Dehydration (as in prolonged or severe diarrhea)
  • Emphysema, severe asthma, or other respiratory disease
  • Macrocytosis (enlargement of red blood cells, often caused by hypothyroid or liver disease or deficiency of B6, B12, folate)
  • Adrenal cortex over-activity
  • Polycythemia vera (bone marrow makes too many red blood cells)
  • Living at high altitude
  • Splenic hypofunction
  • Immune suppression
  • Testosterone supplementation

RBC (or RCC, R.B.C.,R.C.C.) – Red Blood Cell Count or Erythrocyte Count

Normal range: Adult males 4.5 to 5.5 x 1012/L, adult females 3.8 to 4.8 x 1012/L.
OPTIMAL range: Adult males 4.7 to 5.25, adult females 4.0 to 4.5.
Units are trillions (1012) per litre, or millions (106) per cubic mm (mm3) which both give the same result.
An estimate of the number of red blood cells per mm3 of blood.
Low RCC may indicate:

  • Anaemia
  • Blood loss, internal or external
  • Bone marrow failure
  • Iron deficiency
  • Copper deficiency
  • Over-hydration
  • Leukemia
  • Multiple myeloma (cancer of plasma cells in bone marrow)
  • Malnutrition
  • Cell damage
  • Iron deficiency (with a low MCV)
  • Vitamin B6, B12, and/or Folic Acid deficiency (with a high MCV )
  • Chronic Disease
  • Liver dysfunction
  • Kidney dysfunction (also abnormal chemistry tests, BUN, creatinine)
  • Hereditary anemia
  • Free radical pathology
  • Toxic metals
  • Catabolic Metabolism
  • Pregnancy
  • Erythropoietin deficiency, typically those with chronic kidney disease
  • Hemolysis, or RBC destruction caused by transfusions and blood vessel injury
  • Thyroid disorders
  • Adrenal dysfunction
  • Cortisol production dysfunction
  • Chronic bacterial infections

High RCC may indicate:

  • Lung disease
  • Emphysema
  • Pulmonary fibrosis
  • Cigarette smoking
  • Sleep Apnea
  • Living at a high altitude
  • Cystic fibrosis
  • Adrenal cortical hyperfunction (either too much cortisol or too much aldosterone)
  • Anabolic Metabolism (testosterone supplementation)
  • Congenital heart disease
  • Cardiovascular dysfunction
  • Dehydration
  • Kidney disease
  • Renal cell carcinoma (kidney cancer)
  • Immune suppression
  • Transplant rejection drugs
  • Gentamicin and Methyldopa drugs
  • Performance enhancing protein injections and anabolic steroids
  • PV (Polycythaemia Vera) – genetic disease where bone marrow makes too many red blood cells

May help indicate the lifespan of the cells, and indicate problems, but may not indicate the actual problem, so other tests will be required.

Haematocrit, also called HCT or PCV – Packed Cell Volume

Normal Range: Adult males: 40 to 50%, adult females: 36 to 46%.
OPTIMUM Range: Adult males: 42 to 48%, adult females: 39 to 45%
Percentage of red blood cells in the total blood volume.
Low PCV/HCT may indicate:

  • Anaemia
  • Blood loss
  • Low RBC
  • Bone marrow failure
  • Abnormal breakdown of Red Blood Cells
  • Increased production of WBC
  • Leukaemia
  • Adrenal dysfunction
  • Low thymus function
  • Multiple myeloma (cancer of plasma cells in bone marrow)
  • Over-hydration
  • Malnutrition
  • RA (rheumatoid arthritis

High PCV/HCT may indicate:

  • Shock
  • Immune supression
  • Excess RBC
  • Dehydration (typically burns or diarrhoea)
  • Eclampsea (a serious pregnancy condition)
  • Polycythaemia vera – bone marrow makes too many red blood cells
  • Spleen hyperfunction

MCV (Mean Cell Volume or Mean Corpuscular Volume)

Normal adult range: 83 to 101 fL (femtoliters).
OPTIMUM adult range: 87 to 92 fL
Some labs give results in cubic microns, which is identical to the range in femtoliters.
An estimate of blood cell volume, or average volume of red blood cells, or the average amount of space taken by each red blood cell.
May help determine the type of anaemia and/or chronic fatigue syndrome.
Low MCV can indicate:

  • Copper deficiency
  • Iron deficiency
  • Low stomach acid
  • B12 and/or Folate deficiency
  • Rheumatoid arthritis
  • Vitamin deficiency
  • Vitamin B6 deficiency
  • Pregnancy
  • Chronic disease
  • Lead or other toxins
  • Hereditary anemia such as thalassemia or sideroblastic
  • Hemolytic anemia
  • Haemoglobin disorder
  • Blood cell destruction
  • Bone marrow disorder

High MCV can indicate:

  • Hereditary anemia
  • Alcoholism
  • Liver disease
  • Malnutrition
  • Bone marrow problems
  • Chronic lung disease
  • Problem with prescription medication
  • Megaloblastic Anemias (pernicious, folic acid deficiency, B12 deficiency)
  • Reticulocytosis (acute blood loss response. Reticulocytes are immature cells, relatively large in size compared to a mature red blood cell)
  • Artifact (aplasia, myelofibrosis, hyperglycemia, cold agglutinins)
  • Hypothyroidism
  • Anti-convulsant drugs
  • Zidovidune treatment (for AIDS)

MCH (Mean Corpuscular Haemoglobin or Mean Cell Haemoglobin)

Normal range: 27 to 32 picograms
MCH is a calculation determining the amount of oxygen-carrying haemoglobin inside the Red Blood Cells.
Results too high (usually Macrocytic anemia), often caused by too little vitamin B12 and/or folate, in turn often caused by low stomach acid or antacid use.
Macrocytic Red Blood Cells are larger than either normal or microcytic RBCs, tending to have higher MCH values.
The larger cells mean that there are fewer cells, and less haemoglobin is then available.
Results too low (usually Microcytic) may indicate Iron Deficiency Anemia, or a nutritional deficiency.
Normally MCH is elevated or depressed when MCV is elevated or depressed, and usually for the same reasons as MCV.

MCHC (Mean Corpuscular Haemoglobin Concentration)

Normal range: 315 to 345 g/L or often specified as 28% to 36%
OPTIMUM range: 32% to 35%
A calculation of the concentration of haemoglobin inside the Red Blood Cells.
Decreased MCHC values (hypochromia) are when haemoglobin is abnormally diluted inside the red blood cells.
Indicates anemia if the count is low, or possible nutritional deficiencies if high.
Typical causes are iron deficiency anaemia and in thalassaemia.
Increased MCHC values (hyperchromia) are seen in conditions where the haemoglobin is abnormally concentrated inside the red blood cells.
Typically seen in burn patients.
MCHC is increased or decreased in the same conditions as MCV is increased or decreased, except:
1. In spherocytosis (a fairly rare congenital disorder), MCHC is elevated
2. In pernicious anemia, MCHC is normal.

RDW (Red Cell Distribution Width or Random Distribution of red cell Width)

Normal range: 11% to 15%
OPTIMAL Range: 13%
Tests for the shape and size of red blood cells, but the term “width” refers to the distribution, rather than the size of cells.
Liver disease, anemia, nutritional deficiencies, and many health conditions can cause high or low RDW tests.
RDW can be increased in:

  • B12 and Pernicious anemia
  • Folic acid anemia
  • Iron deficiency anemia combined with other anemia
  • Hemolytic anemia
  • Transfusions
  • Sideroblastic anemia
  • Alcohol abuse

RDW can be decreased in:

  • Iron deficiency anemia (blood loss, parasites, poor iron absorption)
  • Vitamin B6 anemia
  • RA (Rheumatoid arthritis)

ESR (Erythrocyte Sedimentation Rate)

Also known as SED (Sedimentation Rate).
A measure of how Erythrocytes (Red Blood Cells) sink in a pipette. The faster the blood cells sink, the higher the inflammation we have.
Inflammation creates proteins that make red blood cells fall faster, giving a higher test result.
The test reports the distance (mm) between the clear liquid (plasma) at the top of the tube and the red blood cells after 1 hour.
The normal range:
Males: 0 to 15 mm/hour
Females: 0 to 20 mm/hour
Seniors may have slightly higher readings.
High ESR can be caused by:

  • pregnancy
  • inflammation
  • infection
  • anemia
  • kidney or other cancer
  • rheumatoid arthritis
  • polymyalgia rheumatica
  • giant cell arteritis (swelling in blood vessel lining)
  • systematic vasculitis (inflammation in blood vessels)
  • multiple myeloma
  • lupus (SLE or systemic lupus erythematotus)
  • IBS (Inflammatory Bowel Disease)

Low ESR can be caused by:

  • polycythemia
  • sickle cell anemia
  • hereditary spherocytosis
  • congestive heart failure

The ESR test is recommended for patients with symptoms of headaches, stiff joints, pain in shoulders, neck or pelvis, appetite loss, unexplained weight loss.

Platelets

Most adults have between 150,000 to 450,000 platelets per mcL (microlitre) of blood.
1mcL is the same as 1 cubic millimetre (mm3).
The OPTIMUM values are 230,000 to 400,000 per mm3.
Platelets are small portions of cells involved in blood clotting, continually made by the bone marrow, as each platelet survives only around 10 days.
Platelets stick together when we cut ourselves to form a clot to stop bleeding.
Too many or too few platelets can affect clotting in different ways, and the number of platelets may also indicate a health condition.
Low platelets (thrombocytopenia) can be caused by:

  • Bleeding
  • Alcoholism
  • HIV
  • Toxins
  • Inherited disorders like Wiskott-Aldrich or Bernard-Soulier
  • Bacterial infections
  • SLE (Systemic Lupus Erythematosus)
  • RA (Rheumatoid Arthritis)
  • Pernicious anaemia
  • Megaloblastic anemia (B12 and/or folic acid deficiency)
  • Hypersplenism (spleen takes too many out of circulation)
  • Leukaemia
  • Chemotherapy
  • Marrow depression (aplastic anemia, radiation, drugs)
  • Marrow infiltration (acute leukemia, carcinoma, myelofibrosis, multiple myeloma)
  • Prescription medications like heparin, quinidine, quinine, sulfa-containing antibiotics, interferon, anticonvulsants and gold salts
  • Immunologic (ITP, infectious mononucleosis (EBV), SLE, Lymphoma, CLL)
  • Dilution due to overhydration (drinking too much water)
  • Coagulation disorders (DIC, septicemia, hemolytic-uremic syndrome, TTP, large hemangiomas, heart valve, eclampsia)
  • Hypersplenism (over-active spleen, removing old blood cells too soon)
  • Platelet aggregation or large platelets
  • Rubella
  • Liver dysfunction (cirrhosis)

Idiopathic Cytopenic Purpura (ITP), a condition possibly related to viral infection, autoimmunity or chemical toxin.

High platelets (essential thrombocythemia) can be caused by:

  • Thrombocythemia (bone marrow makes too many platelets)
  • Gene mutations (Janus kinase 2 [JAK2] gene)
  • Infections
  • Iron deficiency
  • Hemolytic anemia (abnormal breakdown of red blood cells)
  • Acute blood loss
  • Splenectomy (surgical removal of the spleen)
  • Tissue damage, chronic inflammation, surgery
  • Disseminated carcinoma (a condition where cancer cells are spreading)

Mean Platelet Volume (MPV)

Normal range: 7.5 to 11.5 femtoliters
This test measures and calculates the average size of platelets.
Higher MPVs mean the platelets are larger, which could put an individual at risk for a heart attack or stroke.
Lower MPVs indicate smaller platelets, meaning the person is at risk for a bleeding disorder.

The White Blood Cell Test Group

WBC – White Blood Cells (or leukocytes, or sometimes leucocytes)

Normal Range: 4,500 to 11,000 WBC per mcL (micro-litre) of blood, average person around 7,000 (USA labs 4,300 to 10,800 cmm).
A high number can be an indicator of disease.
Part of the immune system which defends against infectious, disease and foreign bodies.
WBC’s live for three to four days in the body, and are found throughout the blood and lymphatic system.
WBC’s make up around 1% of the total blood volume in a healthy adult, and help fight infections. A high white blood cell count may help identify infections.
It may also indicate leukemia, which can cause an increase in white blood cells.
Too few white blood cells may be caused by some medications or health problems.
This test measures the numbers, shapes and sizes of various types of white blood cells.
The WBC differential count (percentage) shows if the numbers of different cells are in proper proportion to each other.
Irregularities may indicate infection, inflammation, autoimmune disorders, anaemia, or other health conditions.

High leukocytes (leukocytosis)

Typically caused by a bacterial or viral infection, the body responding my making more WBC’s.
Typical is bone marrow disease, leukemia, myelofibrosis, smoking, stress, tuberculosis, rheumatoid arthritis, whooping cough.
Also can be caused by reaction to some medications such as antibiotics, diuretics, corticosteroids, epinephrine and others.

Low leukocytes (leukopenia)

Caused by cancer, viral infections of the bone marrow, congenital disorders, autoimmune diseases which attack WBC’s, major infections which use up WBC’s faster than they can be produced, chemotherapy, AIDS, lupus, malnutrition, lack of vitamins, radiation, parasites.
Volume, conductivity, and granularity can change due to activation, presence of immature cells or malignant leukocytes in leukemia.

Five Major Types of White Blood Cells

  • Neutrophils – making up around 62% (can be 40% to 80%) of White Blood Cells, neutrophils attack bacteria and fungi, and live from a few hours to a few days.
    If given as the number of cells instead of a percentage, divide the number by the WBC (White Blood Cells) to get the percentage.
    The bone marrow makes neutrophils and stores them, to be released into the blood in response to physical stress or infections.
    Neutrophils contain enzymes which can break down bacteria, and also contain glycogen and protein for their own energy.
    High neutrophils increase the body’s requirement for protein to replace that used by the bone marrow to make more nuetrophils.
    High Neutrophils (Neutrophilia) can be caused by infection, inflammation, pregnancy, or physical stress (intense exercise).
    Low Neutrophils (Neutropenia) can be caused by B12 and folate deficiency, infections that destroy neutrophils, aplastic anemia, leukemia, autoimmune disease, hypersplenism (spleen enlargement), dialysis, some medications.
  • Eosinophils – making up 2.3% (can be 1% to 4%) of White Blood Cells, eosinophils attack parasites and allergens.
    High eosinophils normally indicate parasitic infections or allergic reactions.
    Low eosinophils can be caused by alcohol intoxication or excess cortisol production.
  • Basophils (also called basophiles, basophilic leukocytes, basocytes, basophilocytes, mast leukocytes) – making up 0.4% (can be up to 1%) of White Blood Cells, basophils release histamine for inflammatory allergic responses.
    High basophils may be caused by bone marrow disease, Chrohn’s disease, removed spleen, when inflammation is healing, asthma, chronic dermatitis, hypothyroidism, Hodgkins lymphoma.
    Low basophils can be caused by hyperthyroidism, allergies, pregnancy, ovulation, immune-suppressing drugs.
  • Lymphocytes – making up 30% (can be 20% to 40%) of the White Blood Cells, living for years as memory cells, months for other types.
    Normal range (adults): 1,000 to 4,800 lymphocytes in 1 microliter (µL) of blood.
    Normal range (children): 3,000 to 9,500 lymphocytes in 1 microliter (µL) of blood.
    Unusually high or low lymphocytes may cause no symptoms or problems on their own,
    and may be the body’s normal response to infection, inflammation or other condition, and often return to normal after some time.
    If there are other tests with unusual results, the doctor should look at all these tests together to determine if further invesatigation is required.
    If levels do not retern to normal, or keep progressing high or low, further investigation is required,
    as this may be diagnosed as lymphocytopenia or lymphocytosis, with symptoms from mild to severe, and the duration depends on the cause.Low lymphocytes (lymphocytopenia) may indicate:

    • Poor immune system
    • Lymphocyte cells are trapped in the spleen or lymph nodes
    • The marrow cannot make enough lymphocytes
    • Something is destroying the lymphocytes

    Some acquired causes of Low Lymphocyte Count:

    • Typhoid fever
    • Viral Hepatitis
    • HIV/AIDS
    • Tuberculosis
    • Aplastic Anemia
    • Myelofibrosis
    • Systemic Lupus Erythematosus (SLE)
    • Hodgkin’s Lymphoma
    • Dengue
    • Radiation and Chemotherapy

    Some inherited causes of Low Lymphocyte Count:

    • Wiskott–Aldrich syndrome
    • Ataxia-telangiectasia
    • DiGeorge Syndrome
    • Severe Combined Immunodeficiency

    High lymphocytes (lymphocytosis) may indicate cancer, autoimmune disorder or severe viral infection.
    Lymphocytes are white blood cells that help defend the body from illness, consisting of three major types: B cells, T cells, and NK (Natural Killer) cells:

    • B cells – release antibodies that fight bacteria and toxins, also assist in activation of T cells
    • T cells attack cells that have been infected by viruses or malignancies, and consist of 4 sub-types:
      • CD4+ (Th or T helper cells) – activate and regulate B and T cells, release T cell cytokines to aid the adaptive immune system to recognise foreign invaders
      • CD8+ (cytotoxic T cells) – tumour cells and virus infected cells
      • γ δ (gamma delta) T cells – bridge between innate and adaptive immune responses (phagocytosis)
      • Regulatory (supressor) T cells – return the immune system to normal functioning after an infection, preventing auto-immune disease
    • NK (Natural Killer) cells – part of the innate immune system, also assisting the adaptive immune system, important in cancer therapy, helping reject tumours and cells infected by viruses,
      killing invaders by releasing small cytoplasmic granules of proteins that literally reprogram the target cells to self-destruct
  • Monocytes – making up 5.3% (can be 2% to 8%) of the White Blood Cells, monocytes migrate from the blood into other tissues as macrophages,
    also into the liver where they become Kupffer cells.

Blood Biochemistry, or Blood Chemistry

Electrolytes

Electrolytes are electrically charged chemicals (ions) that are vital to normal body processes, such as nerve and muscle function.
Electrolytes help regulate fluid in the body and maintain the acid-base balance.
The important electrolytes: Sodium, Potassium, Chloride and Bicarbonate (HCO3).
Normally bundled with the electrolytes are the important mineral tests: Phosphorus, Calcium, Iron, Zinc and Magnesium. Magnesium not normally tested as only about 1% of the body’s Magnesium is in the blood, but very important, as 90% of the population has lower than optimal Magnesium intake. Zinc also seldom tested, but equally important.

Sodium

Normal range: 135 to 145 mmol/L (or mEq/L) depending on the lab.
An essential electrolyte.  Essential for the body to balance water volume and pressure in thee body tissues, carry nutrients into cells and wastes from cells,  for nerve impulses and muscle contractions, automatic functions in the intestinal tract.
Irregularities in levels may indicate dehydration, disorders of the adrenal glands, excessive salt intake, corticosteroids, painkiller medications, liver or kidney problems.
The body keeps sodium levels in the normal range by excreting more or less through the kidneys into urine.
High sodium may raise blood pressure, and/or cause leg swelling in some people.
Many factors affect levels. Shock or trauma may increase levels. Some prescription diuretics, anti-depressants and blood pressure medications deplete sodium.
Drinking too little water can increase levels, drinking too much water can deplete levels.
Excessive sweating or vomiting can reduce sodium levels.
Too much sodium (Hypernatremia) or too little sodium (Hyponatraemia) cause many problems.

Sodium above the range may suggest:

  • Water retention, weight gain (water weight!)
  • High Blood Pressure
  • Dehydration
  • Diabetes
  • Dysfunction of Adrenal Glands

Sodium below the range may suggest:

  • Addison’s Disease (Damaged Adrenal Glands)
  • Severe Diabetes
  • Liver Cirrhosis
  • Kidney damage
  • Diuretic medications
  • Congestive heart failure
  • Excessive sweating
  • Diarrhea
  • Hypothyroidism

Urine Sodium

The amount of Sodium in urine, which is excreted by the kidneys.
Used with other electrolyte tests, and to help determine kidney function.
Reference Range: 20 mmol/L as a random urine test, or 28-272 mmol/L as a 24-hour urine test.
The excretion of sodium varies with dietary intake, and excretion is greater in daytime than at night.
Medications known to interfere with the results:
Corticosteroids

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Prostaglandins (used to treat conditions such as glaucoma or stomach ulcers)
  • Water pills (diuretics)

Low urine levels may be due to:

  • Congestive heart failure
  • Excessive sweating
  • Diarrhea
  • Pyloric obstruction
  • Malabsorption and primary aldosteronism
  • Excess water consumption

Increased urine levels may be due to:

  • Increased salt intake (typically from processed foods)
  • Failure of adrenal glands
  • Diabetic acidosis
  • Salt losing renal (kidney) disease
  • Water deficient dehydration

Potassium

Normal range: 3.6 to 5.2 mmol/L (or mEq/L) depending on the lab.
* A critical level is 5.5 mmol/L and over 6.0 mmol/L can be life-threatening.
An essential electrolyte, required for relaying nerve impulses, maintaining proper muscle functions, and regulating heartbeats. Without Potassium, the heart cannot beat!
The body must keep potassium and sodium levels in balance with each other for correct cell function and nerve transmission. High Potassium may cause a pounding heart, especially when lying down, and increases heart attack risk if high levels maintained over a long time,

High potassium (Hyperkalemia) issues:

  • Kidney disease
  • Adrenal exhaustion
  • Some blood pressure drugs (ACE inhibitors, ARB’s, some Beta blockers)
  • Potassium sparing diuretics
  • Diabetic ketoacidosis
  • Primary aldosteronism
  • Cushing’s syndrome
  • Heavy alcohol use
  • Drug use
  • Anything causing muscle breakdown (which releases potassium into the blood), e.g.Statins
  • Possible false score if the blood specimen is mis-handled

Low potassium levels (Hypokalemia) issues:

  • Irregular heart beat
  • Diuretics (mainly “Loop Diuretics”)
  • Blood pressure drugs (if they include loop diuretics)
  • Loss of body fluids
  • Exhaustion
  • Swollen ankles and fingers
  • Worse menopause symptoms
  • Stress
  • Asthma drugs (such as Abuterol)
  • Antibiotics
  • Diarrhea
  • Anorexia
  • Laxatives
  • Partial paralysis in legs, hands

Constipation can be a symptom of high or low potassium.
Low potassium is a major cause of cardiac arrhythmia, which can be a life-threatening condition.

Chloride

Normal range: 98 to 106 mEq/L (USA labs).
An essential electrolyte, and the body must keep chloride levels in the normal range.
Often will increase (hyperchloraemia) or decrease (hyporchloraemia) with changes in sodium levels (from salt – Sodium Chloride).
Some medications or a diet high in salt can cause high chloride.
Excess chloride may indicate an acidic environment in the body, or dehydration, multiple myeloma, kidney disorders, or adrenal gland dysfunction.

Bicarbonate (total HCO3, total CO2)

Normal Range: 24 to 30 mmol/L (Australia) or mEq/L (USA)
Most of the carbon dioxide in the body is in the form of bicarbonate (HCO3).
An essential electrolyte, part of a standard blood electrolyte panel, and part of a renal (kidney) function test, lung test or metabolic test.
Normally taken from a vein (in the crook of the elbow), but for some lung tests, it is taken from an artery, usually in the wrist, for an ABG (Arterial Blood Gas) test.

ABG (Arterial Blood Gas)

Taken from an artery to test for various gases which may indicate problems with the heart, lungs, metabolism or kidneys.
Not normally tested unless there is a serious illness.

Serum Anion Gap

Anion Gap (AG or AGAP) is the difference between measured cations and measured anions in serum.
This difference does not reflect a true disparity between positive and negative charges,
because serum is actually electrically neutral when all serum cations and anions are measured.
Rather, the anion gap is a measurement artifact resulting from the fact that only certain cations and anions are routinely measured.
Cations are ions with a positive electric charge. Anions are ions with a negative electric charge.
Anion gap metabolic acidosis is secondary to the addition of endogenous or exogenous acid.
Anion Gap can be calculated in different ways, but commonly the sum of common cations less the sum of common anions:
Serum Anion Gap (AG) = Sodium (Na+) + Potassium (K+) less the sum of (Chloride Cl) and Bicarbonate HCO3)
Sometimes the potassium is ignored, as it is comparatively small compared to Sodium, giving different results:
Reference range for serum Anion Gap is 8 to 16 mmol/L or mEq/L (without potassium)
Reference range for serum Anion Gap is 12 to 20 mmol/L or mEq/L (with potassium)
Normal Anion Gap is specific to laboratory and equipment used.
Newer technology and equipment have been shown to measure “low” Anion Gap in otherwise normal, healthy people.
Because there are other chemicals with anions in the body, a test below 11 is considered normal.
If test results are unexpected, the doctor may ask for a test repeat, as errors in any of the electrolyte tests will give an incorrect Anion Gap calculation.
A high Anion Gap, typically over 20, can indicate:

  • Lactic Acidosis (high blood lactic acid level), e.g. from over-exercising
  • Diabetes where ketones break down causing diabetic ketoacidosis
  • Starvation causing ketoacidosis
  • Alcoholic ketoacidosis
  • Poisoning, e.g. methanol, aspirin, carbon monoxide, cyanide, anti-freeze (ethylene glycol)
  • Toluene poisoning
  • Paracetamol (Acetaminophen) overdose
  • Paraldehyde overdose
  • Iron overdose
  • Kidney failure, when kidneys cannot take in bicarbonate which is then lost in the urine
  • Uremia (urea in the blood)

A low Anion Gap can be caused by:

  • Hyponatremia (decreased sodium in the blood)
  • Multiple myeloma (cancer of plasma cells in bone marrow)

Other causes of low Anion Gap, although less common:

  • Bromide (negatively charged) intoxication, from some sedative drugs, medication for myasthenia gravis, and some herbal medications.
    High bromide can lead to neurologic or dermatologic symptoms. Bromide can interfere with chloride calculation, giving a false low Anion Gap.
    Bromide is often used in heated spas as a disinfectant, where it is readily absorbed through the skin, also blocking thyroid uptake of Iodine
  • Lithium is positively charged, often prescribed for bipolar disorder, and high concentrations may lower Anion Gap
  • Increase in positively charged ions such as calcium and magnesium can also lower the Anion Gap

Urine Anion Gap

The Urine Anion Gap test where the ammonium ion (NH4+) is the main positive ion (Cation).
However, Urine NH4+ is difficult to measure directly, but its excretion is normally accompanied by the anion chloride,
So the Urine Anion Gap is calculated by the sum of Urine Sodium plus Urine Potassium less Urine Chloride (Na+ + K+ – Cl)
Bicarb is omitted in this formula because urine is generally acidic, and Bicarbonate is generally negligible.
Note that urine values are different from serum values, so these results cannot be interchanged in the formula.
Typical values of Urine Anion Gap:
0 to 10 mmol/L (or mEq/L), and values over 10 mean the body is more acidic (undesirable).
Urine Anion Gap result over 20 indicates metabolic acidosis, usually when the kidneys cannot excrete ammonia, e.g. in renal tubular acidosis.
A negative Urine Anion Gap can be used as evidence of increased NH4+ excretion.
A zero or negative Urine Anion Gap while the Serum Anion Gap is positive, suggests a high urinary NH44+ (probably caused by gastrointestinal, e.g. diarrhea or vomiting).

Glucose

The amount of glucose in the blood at the time of the test. A relatively constant level of glucose must be maintained in the blood.
For a more helpful test, see the HbA1c test.
Should always be a fasting test, minimum 2 hours after a meal, but preferably fasting overnight after at least 6 hours without food or drink other than water.
Normal range is around 3.2 to 5.5 mmol/L (70 to 100 mg/dL in USA labs).
Results below this range is hypoglycaemic (low blood glucose) and urgent medical attention is required.
Elderly people generally test higher, even if they are healthy.
Levels are affected by food or drink recently ingested, recent exercise, stress levels, medications, hydration and the time of day.
Ranges above 5.5 are hyperglycaemic (high blood glucose).
5.5 to 6.9 is considered pre-diabetic, and over 6.9 is diabetic.
Doctors normally prescribe Metformin (with nasty side-effects) rather than refer to a nutritionist who can advise elimination of sugar,
high-carbohydrate and processed foods from the diet, and use magnesium supplements,
which in nearly every case will eliminate diabetes as well as reduce excess weight and improve cardiovascular health and reduce risk of dementia.

Random Glucose Level

Also called RBC (Random Blood Glucose) or CBG (Casual Blood Glucose). A recent meal is assumed, so has a higher reference range than the fasting glucose test above.
Typical range for a normal adult is 4.4 – 7.8 mmol/L (Australia) or 79 – 140 mg/dl (USA).
Results above this may not indicate diabetes (could also be a recent high sugar or carbohydrate meal), but a fasting glucose test should then be carried out to confirm if diabetes is suspected.

The Kidney Function Group of Tests

Note that kidney issues often show no symptoms until they are both working as low as 10% capacity,
so regular testing is advised to capture problems early while changes to diet, medications and lifestyle can correct the issues.
Some symptoms of kidney dysfunction include fatigue, swelling and hypertension.
The Kidney Panel usually consists of the following tests:
Electrolytes, –

Minerals include:

Phosphorus, vital for energy production, muscle and nerve function, bone growth and as a buffer to maintain the acid-base balance.
Calcium, essential for the proper functioning of muscles, nerves, and heart, also for blood clotting and bone formation.

Protein
Albumin – a protein that makes up about 60% of protein in the blood. Roles include keeping fluid from leaking out of blood vessels, and transporting hormones, vitamins, drugs, and ions like calcium throughout the body.
Waste products
Three calculated values may also be reported with a renal panel:
Estimated Glomerular Filtration Rate (eGFR) – a calculated estimate of the actual glomerular filtration rate (GFR, the amount of blood filtered by the glomeruli in the kidneys per minute) derived from creatinine levels in the blood; the formula takes into account the person’s age, gender, race, and sometimes height and weight.

Urea, or BUN (Blood Urea Nitrogen)

Urea, or BUN (Blood Urea Nitrogen) is a nitrogen-containing waste product that forms from metabolism of protein.
Released by the liver into the blood and is carried to the kidneys, where it is filtered out of the blood and eliminated in the urine.
Normal Range: 2.5 to 7.1 mmol/L or 10 to 20 mg/dL (USA labs). Not always tested in Australia.
High levels indicate poor kidney function, and results should be looked at in combination with the creatinine test.
May also be influenced by function.
Many medications and/or a high-protein diet can also raise BUN levels.

BUN/creatinine ratio

Urea (BUN)/creatinine ratio is a comparison of urea (nitrogen) to creatinine content in the blood.
Normal Range: Ratio of BUN to creatinine: 10:1 to 20:1 (men and older individuals may be somewhat higher)
Shows if kidneys are eliminating waste correctly.
High levels of creatinine, a by-product of muscle contractions, are excreted through the kidneys and suggest reduced kidney function.

Creatinine (Serum)

To determine if kidneys are functioning normally.
This test is used in conjunction with Urea and eGFR tests.
This is a waste product, disposed of by the kidneys, so any elevation may indicate kidney problems.
Creatinine is not re-absorbed or recycled, so if the kidneys cannot eliminate creatinine through the urine, levels will continue to rise.
High levels may also be caused by muscle problems, such as rhabdomyolysis (breakdown of muscle) often caused my statin medication.
Body builders may take Creatine supplements (not the same thing as creatinine) which is a natural product made by the body, but breaks down into creatinine,
and will increase the creatinine test results. Creatine has been shown to increase water retention in some people, causing swollen ankles,
but this mainly occurs in those with poor kidney function, and the doctor should order a series of kidney tests.
Certain chemicals can cause analytic interference of Creatinine measurements.
Ketoacids (such as occurring in diabetic ketoacidosis) and 5-aminolevulinic acid (sometimes administered for photodynamic therapy) interfere with the alkaline picrate (Jaffé) assay of creatinine, giving falsely high readings and the incorrect impression of kidney dysfunction.
The issue does not arise with enzymatic creatinine measurements, so different labs using either the Jaffé assay or the enzymatic method will give different results.
Note also that Amlodipine and some similar blood-pressure medications, cause increased Creatinine, often resulting in swollen ankles, indicating kidney dysfunction, especially for those who are male, over 60 years old, and also take the drug Furosemide, and also have high cholesterol.
Other drugs such as Cimetidine, Trimethoprim, Corticosteroids, Pyrimethamine, Phenacemide, Salicylates, and active Vitamin D metabolites, can also increase plasma Creatinine without influencing glomerular filtration, thought to be through inhibition of Creatinine secretion, so a urine creatinine test would perhaps show a reduced level of creatinine compared to the increased serum results.
This is the blood (serum) test. See also the Creatinine Urine test below.
Normal range:
Men (18 to 60 years): 80 – 115 umol/L (Australia) or 0.9 to 1.3 mg/dL (USA)
Women (18 to 60 years): 53 – 97 umol/L (Australia) or 0.6 to 1.1 mg/dL (USA)
The elderly may test a little lower.
Men (60 to 90 years): 71 – 115 umol/L (Australia) or 0.8 to 1.3 mg/dL (USA)
Women (60 to 90 years): 53 – 106 umol/L, some labs say 45 to 90 umol/L (Australia) or 0.6 to 1.2 mg/dL (USA)

Creatinine (Urine)

Kidneys filter creatinine from the blood, excreting it through urine. The creatinine urine test may detect kidney malfunctioning.
This test is normally performed as a 24-hour urine test.
All urine is collected for 24 hours, stored in the refrigerator (not frozen), mixed and the result poured into a small sample bottle and labelled as such.
If a 24-hour test cannot be performed, a mid-stream urine sample from the first morning urination can be used, but results will not be as accurate, as urine creatinine levels change normally throughout the day.
Creatinine is a metabolic waste product of muscle metabolism and meat consumption, so those with a high protein diet, or very muscular, or have muscle damage, will have higher levels.
Urine creatinine levels may fluctuate depending on race, muscle mass, diet and certain medications.
Labs usually do not specify a normal range, as results can vary, and the test is generally used in conjunction with other tests to determine kidney function.
Normal range (subject to many factors, check with your doctor or laboratory if results appear out of range):
Men: 1.7 to 28 mmol/L (20-320 mg/dL USA labs)
Women: 1.7 to 24 mmol/L (20-275 mg/dL USA labs)

Creatinine Clearance

How fast creatinine is cleared by the kidneys, another way of estimating kidney function.
Low test results may mean kidney problems such as tubule damage, kidney failure, restricted kidney blood flow, kidney filtering unit damage, dehydration, obstructed bladder outlet, heart failure.
Normal Range:
Men: 97 to 137 ml/min. (all labs)
Women: 88 to 128 ml/min. (all labs)

eGFR (Glomerular Filtration Rate)

Used to screen for early kidney damage and to monitor kidney status. Performed by the creatinine test and calculating the estimated Glomerular Filtration Rate.
The creatinine test is ordered as part of a routine metabolic panel, or along with a Blood Urea Nitrogen (BUN) test to evaluate the kidney status,
or to monitor those with known chronic kidney disease and those with diabetes and hypertension which may lead to kidney damage.
A low rate means some kidney damage has occurred.

KIDNEY DAMAGE STAGE DESCRIPTION GFR OTHER
1 Normal/minimal kidney damage with normal GFR 90+ Protein or albumin in urine are high, cells or casts seen in urine
2 Mild decrease in GFR 60-89 Protein or albumin in urine are high, cells or casts seen in urine
3 Moderate decrease in GFR 30-59
4 Severe decrease in GFR 15-29
5 Kidney failure under 15

Related test: Cystatin C

Often used as an alternative test to eGFR.
Kidney damage can cause gynecomastia in men due to decreased testosterone levels, leading to greater estrogen/testosterone ratio.

Cholesterol (total)

A fairly meaningless test – see Cholesterol (Lipid) Testing below.
Labs use around 0.0 to 5.4 nmol/L for a normal range, but very low levels, or rapidly dropping levels can indicate a higher risk for cancer, anxiety, depression, and if pregnant, premature birth and low birth weight.
High levels are a signal for doctors to prescribe statin drugs, when the cause should be investigated
(inflammation, which causes the body to make more cholesterol to repair the damage caused by inflammation).
Many smarter doctors are now agreeing with the science: Cholesterol is not bad, and unless levels go into the 8.0 area and above, there is not a huge problem as long as HDL levels are high enough.

Urate (Uric Acid)

Produced by the breakdown of purines. Normal range, Men: 0.208 to 0.416 mmol/L (3.5 to 7.0 mg/dL), desired range less than 0.36mmol/L (6.0 mg/dL)
Sometimes units given as µmol/L which is mmol/L / 1000, e.g. 0.416 mmol/L = 416 µmol/l.
Excess uric acid (Hyperuricemia) is excreted by the kidneys and disposed in the urine and faeces.
It is normal to have some Uric acid in urine.
High uric acid causes crystals to form in the joints – a painful condition known as gout, often in the big toe joint,
although not everyone with high uric acid has a problem. Some with levels up to 0.571 mmol/L (9.6 mg/dL) still have no gout.
Men are much more likeley to have gout than women up tp ages 50 to 60,
probably because testosterone aggravates gout, and men lose a large amount of testosterone and often gain excess body fat in senior years.
High Uric acid can increase risk of diabetes, cardiovascular disease and ammonium acid urate kidney stones.
High Uric acid (Hyperuricemia) can be caused by:

  • Obesity or excess body fat
  • High purine foods
  • Thiazide diuretics (hydrochlortiazide)
  • ACE inhibitors and beta blockers
  • Loop diuretics (including Furosemide or Lasix®)
  • Anti-TB (Tuberculosis) drugs
  • Chemotherapy drugs
  • Immune suppressing drugs
  • Other drugs including:
    • Acitretin
    • Didanosine
    • Filgrastim
    • L-dopa
    • Omeprazole
    • Peg-interferon + ribavirin
    • Sildenafil
    • Teriparatride
    • Ticagrelor
    • Topiramate
  • Vitamin B3 (niacin), mainly high doses
  • Insulin resistance (type 2 diabetes)
  • Fasting or rapid weight loss, usually temporary
  • Low dose Aspirin (60 to 300mg daily)
  • Fructose (generally from fruit juices or foods sweetened with HFCS – High Fructose Corn Syrup)
  • Apples, peaches, pears, plums, grapes, prunes, dates all contain fructose, but OK in moderation
  • Yeast containing foods: Vegemite, Marmite, bread
  • Xylitol, a natural sweetener
  • Glycerol
  • Sorbitol
  • Testosterone
  • Recent surgery or trauma

Low uric acid (Hypouricemia) may indicate, cause or be caused by:

  • Hyperthyroidism
  • MS (Multiple Sclerocis)
  • Fanconi Syndrome (Kidney disease, genetic, from some drugs or heavy metals),
  • Myeloma (Cancer of blood plasma cells in bone marrow)
  • Nephritis (Kidney inflammation)
  • Wilson’s Disease (genetic, causing copper accumulation)

Phosphate (Phosphorus)

Normal range: 0.8 to 1.4 mmol/L (2.5 to 4.3 mg/dL)
Phosphorus is important for bone health, energy storage, nerves and muscles, and related to calcium levels, which should be read in conjunction.
High phosphorus (Hyperphosphatemia) may indicate kidney or parathyroid problems, alcohol abuse, long-term antacid use,
excessive diuretics, malnutrition or high/low vitamin D.
Meat, dairy products and other foods contain phosphorus, so insufficiency (Hypophosphatemia) is rare.
Liver disease and low vitamin D can cause high or low phosphorus levels.
Low phosphate (Hypophosphataemia) can be caused by poor nutrition, low vitamin D3, poor absorption.
Extra-low (less than 0.4 mmol/L) may be caused by redistribution into cells, kidney losses or low intake.
Often accompanies other electrolyte deficiencies.
The test results will not determine the cause of high or low readings, so more tests are then required.

Total Calcium

The amount of calcium circulating in the blood, normal range 2.10 to 2.55 nmol/L (USA labs 9.0 to 10.5 mg/dL). Elderly people usually test a little lower.
Calcium levels over 3.0 (Hypercalcaemia) are a cause for further investigation, as high levels can increase risk of blood clots, and may indicate other problems.
Possible causes are Sarcoidosis, too much or too little Vitamin D, kidney problems, over-active thyroid or parathyroid, some cancers (such as lymphoma, parathyroid, and pancreatic).
This test does not tell us how much calcium is in the bones and teeth, where most of the calcium is stored, only the amount in the blood.
If out of range, additional tests may be required for ionised calcium, urine calcium, phosphate, magnesium, vitamin D and PTH (parathyroid hormone).
Normally, the Parathyroid hormone (PTH) and vitamin D control blood calcium levels within a narrow range of values. See the PTH section for more info.
Low calcium (Hypocalcemia) may be caused by low vitamin D3, poor intestinal absorption, the amount of phosphate in the blood, anorexia or poor nutrition.
Low calcium may cause cramps and twitching.

Calc.IC – Ionised Calcium

Normal Range 1.10 to 1.25 nmol/L
Usually included in the standard tests.
This test result in normal people is inversely related to PTH (parathyroid hormone) so the PTH test is required if Ionised Calcium is out of range.

The Liver Function Group of Tests

These tests should be called “Liver Damage Tests” instead of “Liver Function Tests” as they only report problems when damaged liver cells leak enzymes into the blood, and the
liver can lose significant function before abnormalities show up in these tests: Bilirubin, CGT, AST, ALT and ALP.
These tests are looked at in conjunction with the blood proteins: Globulins, Albumin and Fibrinogen.

Albumin

Normal range: 37 to 48 g/L. USA labs often say 3.9 to 5.0 g/dL (39 to 50 g/L)
A protein made by the liver. Helps stop blood from leaking out. A high number indicates good health.
Results at the low end of this range indicates poor health. Possible causes of low numbers are:

  • Liver or kidney disease
  • Malnutrition
  • Malabsorption in the intestines

The doctor may then order a prealbumin test and other tests to determine the nature of the problem.

Urine Albumin

Reference range: 0 to 25.0 mg/L (Australia and USA)

Albumin/Creatinine Ratio – Urine

Reference range: 0 to 3.5 mg/mmol

Globulins

Simple proteins found in the blood. Range depending on many factors: 21 to 41 g/L
Globulins are a family of globular proteins with a higher molecular weight than albumins. They are insoluble in pure water, but dissolve in dilute salt solutions.
Some are produced in the liver, others are made by the immune system.
There are four different globulin groups: gamma (immune system), beta (hormone transport), alpha-1 and alpha-2 (clotting function).
Individual groups may be tested if further diagnosis is required.
Low test results may indicate liver disease, IBS (Irritable Bowel Syndrome) or inability to digest or absorb proteins, celiac disease, cancer, anaemia, kidney disease, poor immunity and more.
High test results may indicate a chronic or infectious disease, leukemia or other bone marrow disease, autoimmune disease like lupus or rheumatoid arthritis, kidney or liver disease, or carcinoid tumours.

A/G ratio (albumin/globulin ratio)

Healthy ratio: A little over 1.0, which means more albumin than globulin.
The blood contains two types of protein: albumin and globulin.
The A/G ratio test compares levels of these proteins with one another.

Serum Protein

Typically total proteins are the sum of albumin and globulin.
Normal Range 64 to 83 g/L
High levels can be caused by dehydration or other factors. See the notes on Albumin and Globulin.
Low protein is when Albumin and/or Glogulin levels are low, and indicates poor health.

Total Bilirubin

Bilirubin is the yellow-coloured pigment in the bile, produced as the liver breaks down heme from hemoglobin in old red blood cells,
and gives stools the normal brown colour as it is excreted.
Bilirubin is a lipophilic antioxidant, reducing lipid peroxidation (oxidative degradation of lipids),
where free radicals steal electrons from lipids in cell membranes, causing cell damage.
Low bilirubin is associated with an increase in all-cause mortality, but most doctors do not know this,
they say that low levels mean better health!
Range (Total): 2 to 20 umol/L or USA Labs: 0.3 to 1.9 mg/dL.
Range (Direct) 1.0 to 5.1 umol/L or USA Labs: 0 to 0.3 mg/dL.
Different ranges apply for babies and between labs.
High levels can indicate poor function of liver and kidneys, problems in bile ducts, and anaemia, and usually indicate the need for further tests.
However, if further tests reveal no issues with liver or other organs, high bilirubin is a good thing, leading to higher glutathione and a longer, healthier life.
Bilirubin in the blood circulates in two forms:
Indirect (unconjugated) bilirubin – insoluble in water – changed in the liver to a soluble form.
Direct (conjugated) bilirubin – soluble form – made in the liver from indirect bilirubin.
Total bilirubin and direct bilirubin levels are measured directly in the blood, while indirect bilirubin is calculated from the total less the direct bilirubin.
High bilirubin (hyperbilirubinemia) cause skin and/or whites of the eyes to appear yellow (jaundice),
caused by liver disease (hepatitis), blood disorders (hemolytic anemia), or blockage of the bile ducts from the liver to the small intestine.
Hyperbilirubinemia in a newborn baby may cause brain damage (kernicterus), hearing loss, problems with eye movement muscles,
physical abnormalities, and even death.
Babies who develop jaundice can be treated with phototherapy (special lights or a “light blanket”) or a blood transfusion
to lower their bilirubin levels.
When the liver is mature enough to control bilirubin, all symptoms disappear and no further treatment is required.
Standard blood tests only test for total bilirubin and other tests are prescribed only if results or symptoms determine the need for more tests.

GGT (Gamma-Glutamyltransferase)

A very sensitive enzymatic indicator of liver disease.
Common reasons for elevated values can indicate alcoholic cirrhosis (from heavy drinking, or consumption of other liver-toxic substances).
A healthy liver can only detox one alcoholic drink in two hours, so those people who consume two drinks in one hour have a quadruple liver-overload condition.
Used to determine if raised alkaline phosphatase is due to skeletal disease (normal range GGT) or indicate hepatobiliary disease (raised GGT).
Normal range varies – small children approx 7 to 19 U/L (male), 6 to 29 U/L (female) with the high side increasing with age to 50 and above for the elderly.
Adult level range usually around 0 to 45 U/L but always check with the lab and the doctor for your appropriate range.
(GGT) activity is seen in any and all forms of liver disease, although the highest elevations are seen in intra- or post-hepatic biliary obstruction.
Excess alcohol consumption will increase CGT.
High GGT combined with high ALP indicates some form of hepatobiliary disease.

ALP (Alkaline Phosphatase)

Normal range: varies from 45 to 115 U/L (adult male) and 55 to 142 U/L (adult females). USA labs often say 44 to 147 U/L.
OPTIMAL range: depends on age. Adolescents have a much higher ALP when rapidly growing compared to a fully grown adult because the osteoblasts are laying down bone very rapidly.
For adults, 50 to 75 is considered a reasonable optimal range.
Children and female ranges are very varied so always check with the lab for the correct range for your age and sex.
The SI units IU/L are the same as the US units U/L.
ALP is a group of enzymes present mainly in liver (isoenzyme ALP-1) and bone (isoenzyme ALP-2), with lesser amounts in the intestines (isoenzyme ALP-3),
the placenta, the kidneys (in the proximal convoluted tubules) and in white blood cells.
When any of these cells are damaged, ALP is released into the bloodstream.
The ALP enzyme is synthesised in the hepatocytes adjacent to the biliary canaliculi.
Elevations typically indicate problems with bone disease, the liver or obstruction.
Obstruction can be in the biliary tract, which may occur within the liver, the ducts leading from the liver to the gallbladder,
or the duct leading from the gallbladder through the pancreas that empty into the duodenum (small intestine). Any of these organs (liver, gallbladder, pancreas, or duodenum) can be involved.
High ALP can indicate:

  • Liver, Obstruction or Congestion:
    • Cholestasis (decrease in bile flow)
    • Obstructive jaundice (the liver responds to biliary obstruction by synthesising more ALP)
    • Oral contraceptives
    • Obstructive pancreatitis
    • Hepatitis/Mononucleosis/CMV
    • Congestive heart failure
    • Parasites
    • Malignancy involving liver
    • Giant Cell Arteritis, especially with Cholestasis
  • Bone / Skeletal issues involving osteoblast hyperactivity and bone remodeling:
    • Paget’s disease
    • Rickets
    • Shingles (Herpes Zoster virus)
    • Osteomalacia
    • Osteogenic sarcoma
    • Fractures
    • Osteoporosis treatment
    • Adrenal cortical hyperfunction
  • From other conditions:
    • Pregnancy (late, as the placenta produces ALP)
    • Hyperparathyroidism
    • MEN II (Multiple endocrine neoplasia)
    • Leukemia
    • Lymphoma
    • Amyloidosis
    • Granulation tissue
    • Gastrointestinal inflammation (Inflammatory Bowel Disease, Ulcerative colitis, Crohn’s, ulcers)
    • Systemic infections (sepsis)
    • Sarcoidosis
    • Rheumatoid arthritis
    • Hodgkin’s Lymphoma, gynecologic malignancies and some other cancers
    • Acute tissue damage in the heart or lungs (myocardial or pulmonary infarctions)

Low ALP can indicate:

  • Zinc deficiency
  • Hypothyroidism
  • Vitamin C deficiency or Scurvy
  • Folic acid deficiency
  • Excess Vitamin D intake
  • Low phosphorus levels (hypophosphatasia)
  • Celiac disease
  • Malnutrition with low protein assimilation (including low stomach acid production/hypochlorhydria)
  • Insufficient Parathyroid gland function
  • Pernicious anemia
  • Vitamin B6 insufficiency
  • Hypophosphatasia
  • Protein deficiency
  • Wilson disease

ALT (Alanine Aminotransferase)

Also known as Serum Glutamic Pyruvic Transaminase, or SGPT
Normal range: adult males: 7 to 55 U/L, adult females: 7 to 45 U/L depending on age and lab.
Some USA labs say 8 to 37 U/L, some Australian labs say 0 to 54 U/L.
OPTIMAL Range: 20-30 U/L
This test checks for elevated liver enzymes. Note that if the patient is taking high-dose
Niacin, it is normal to have elevated ALT.
Of course, it is NOT normal to have VERY high ALT, and medical advice should be sought, but a little over the normal range can be contributed to Niacin,
and this is not a problem by itself, but should be taken into account if there are other abnormal liver tests.
The other common cause for high ALT is drinking too much alcohol. A healthy liver can detox one alcoholic drink in around 2 hours.
If the patient has 4 drinks in 4 hours, then the liver is double-overloaded and suffers accordingly.
The solution? Stop drinking alcohol!
Diagnosis of liver disease associated with hepatic necrosis (hepatic = liver, necrosis = cell death).
When the liver is fine, results are within range, the lower the better.
High ALT is seen in parenchymal liver diseases where hepatocytes are destroyed, with values often ten times above normal, sometimes as high as one hundred times the upper reference limit.
In some liver infections or inflammatory conditions, ALT is usually higher or as high as AST, and the ALT/AST ratio (normally less than 1), becomes greater than 1.
ALT increases usually occur prior to appearance of symptoms of disease. The liver can lose a lot of function before symptoms appear.
High ALT results can be from other causes, such as:

  • Liver damage such as viral hepatitis
  • Acute lymphocytic leukemia (ALL)
  • Lead poisoning
  • Drug reactions
  • Carbon tetrachloride exposure
  • Large tumor necrosis (decay)
  • Shock
  • Mononucleosis
  • Excessive alcohol consumption
  • Panadol, Parecetamol, Acetaminophen, Tylenol
  • Rapidly growing children
  • Cirrhosis
  • Liver cancer
  • Heart attack
  • Thyroid disease
  • Polymyositis
  • Severe burns
  • Pancreas, Kidney or muscle injury
  • Strenuous exercise
  • Antibiotics, statins, chemotherapy, aspirin, narcotics, and barbiturates
  • Herbs such as echinacea or valerian
  • Injections into a muscle
  • Recent cardiac catheterization or surgery
  • Hemochromatosis
  • Liver ischemia (Lack of blood flow to the liver)
  • Taking high strength Niacin

ALT values are normally compared to ALP (alkaline phosphatase) and AST (aspartate aminotransferase) to diagnose which form of liver disease is present.

AST (Aspartate aminotransferase)

Also called SGOT, Serum Glutamic-Oxaloacetic Transaminase, GOT, Aspartate Transaminase

Normal range: around 8 to 48 U/L, some labs say 0 to 45 U/L, some USA labs say 10 to 34 U/L
An enzyme found in the liver, heart, skeletal muscle and kidneys, in both the cytoplasm and mitochondria of cells.
Not always related to the liver. Elevated values typically mean disease of the heart, muscle, liver, or all.
Mild tissue injury caused the main form of AST to be the cytoplasm form, and major tissue damage results in higher mitochondrial enzyme.
High AST may be found in myocardial infarction (heart attack), acute liver cell damage, viral hepatitis and carbon tetrachloride poisoning.
More moderate rise in AST can be caused by muscular dystrophy, dermatomyositis, acute pancreatitis and crushed muscle injuries.

LD or LDH (Lactate Dehydrogenase)

Normal range: Approx 110 to 230 U/L depending on the lab.
Lactate dehydrogenase is an enzyme, found in almost every living cell, but mostly in the heart, liver, muscles, kidneys, lungs and blood (erythrocytes).
LDH catalyzes the conversion of lactate to pyruvic acid and back, as it converts NAD+ to NADH and back.
A dehydrogenase is an enzyme that transfers a hydride from one molecule to another.
Used to monitor changes in tumour burden after chemotherapy.
High LD is common in cancer patients but results are too erratic to formally diagnose cancer.
High LD generally means that mitochondrial function is compromised, meaning that newly diagnosed cancer patients will have a poor outlook.
High LD is also seen in:

  • Megaloblastic anemia
  • Untreated pernicious anemia
  • Hodgkin’s disease
  • Abdominal and lung cancers
  • Severe shock
  • Hypoxia (reduced oxygen)

Moderatly high LD is seen in:

  • Myocardial infarction (heart attack)
  • Pulmonary infarction
  • Pulmonary embolism
  • Leukemia
  • Hemolytic anemia
  • Infectious mononucleosis
  • Progressive muscular dystrophy
  • Liver and kidney disease

Other tests outside the standard blood tests

Vitamin D3 (25-hydroxycholecalciferol) Testing

Not normally tested unless it is asked for, but given that two-thirds of Australians have less than the minimum vitamin D3,
and nearly 98% have less than optimum levels, and almost 97% of all cancer patients have less than optimal vitamin D3, this test should be mandatory.
Those most at risk include:

  • Those who shower every day, as showering washes off the pre-vitamin D compounds absorbed from sunlight the day before
  • Those with dark skin or wear clothing covering most of the body
  • Those who slip, slop, slap, which is the WRONG thing to do except on cloudy days
  • Those who live further from the equator, where the sun is seldom high in the sky
  • Those who are aged 50 or older, because as we age, we lose the ability to synthesise vitamin D from sunlight
  • Those who work nights and sleep in the day, restricting sunlight exposure
  • Those taking statin medications for cholesterol, as these medicationss prevent the liver from making the ingredients to manufacture vitamin D

Most of the labs say we need from 60 to 160 nmol/L, some medical institutions say we need 20 to 95, and most doctors accept the lab results.
Some labs are now revising their optimal range upwards: 75 to 250 nmol/L.
What we REALLY need is: For healthy bones, we need minimum 90, up to 175.
The OPTIMAL range for IMMUNITY to all disease including most cancers is 125 to 175 nmol/L, preferably in the high end of this range.
For short-term treatment of cancer or other serious illness, we should aim for levels in the 160 to 250 range.
While it is true that vitamin D can be toxic in very high doses, the average dose sold in most stores is 1000 IU which is nowhere near enough.
LeanMachine recommends 5000 IU Vitamin D3, typical cost approx. $20 for 360 gelcaps (almost a year’s supply) at 5 times normal strength.
No cases of toxic overdose of vitamin D3 has been recorded at less than an intake of 40,000 IU.
LeanMachine also gets a lot of sunlight, but still needs this dosage to maintain levels of around 150 to 160 nmol/L.
The body’s organs have the ability to turn Vitamin D into Calcitriol, which goes to work repairing damage from infections, diseases and cancers.
Vitamin D, D2 or D3 – vitamin D3 is the ONLY vitamin we should take as a supplement.
Avoid products “fortified with vitamin D” as these almost always contain vitamin D2, a cheap, synthetic version of natural D3, which not only do not do the same job as real D3,
they actually block absorption of real D3, leaving us D3 deficient.
For the full article on vitamin D3 go to Vitamin D3 fact sheet.

Vitamin B12 (Cobalamin)

Unlike other B group vitamins which are flushed away in urine daily, B12 can last for months in the body, even though it is also water-soluble.
People who have problems taking supplements can get a B12 injection every 3 months.
Normal Range 148 to 616 pmol/L depending on the lab and other factors.
Low levels may be caused by malabsorption in the small intestine, low stomach acid, taking antacids, hyperthyroidism, parasites, pernicious anaemia or dietary insufficiency.
Vegans and vegetarians do not get B12 from plant foods except small amounts in mushrooms.
High levels may be caused by liver disease (cirrhosis or hepatitis), some types of leukemia or taking too many B12 supplements.
Health Departments recommend 2 to 5 mcg daily, but LeanMachine takes 1000 mcg daily, with test results more than double the maximum normal blood range at around 1500 pmol/L.
High doses of B12 do no harm, unlike folate – see next section.
Note: Cheap B12 supplements contain a small amount of cyanide, which is flushed away completely harmlessly in the urine.
Of course, no one should take several bottles at once, and any excess probably offers no extra benefit.
LeanMachine only recommends the
active methyl B12 which has no cyanide.
Essential as we age, because we get older, we produce less stomach acid, so produce less B12.
Up to 30% of people over 50 cannot correctly absorb and make B12 and are deficient, so supplementation is essential in the elderly.
Studies show that over 3% of people over 50 are SEVERELY deficient in B12.
Not normally tested unless we ask for it, but very important for most people over 45 or for vegans and vegetarians.
B12 is chemically the most complex vitamin, and the only water-soluble vitamin that is stored in the body for months or years, but vegetarians and especially vegans as well as most people over 50 should supplement.
Essential for anyone taking PPI (Proton Pump Inhibitors) like Nexium, which reduce stomach acid – giving short-term relief for heartburn, but impacting B12 production and adequate nutrition.
The only effective way to treat heartburn is to eat less, and only eat nutritious food.
Should always be tested along with folate, as high folate can mask B12 deficiency and vice versa – see folate test below.
Recommended : Active B12

Folate (Vitamin B9) – Testing

NOTE: Folic Acid is a cheap substitute for folate, but is not the same thing. Read more below…
Range: Folate in plasma: 7 to 30 nmol/L, folate in Red Blood Cells: 317 to 1422 nmol/L.
High folate may mask a B12 deficiency as B12 is used to process folate. Low B12 means folate is not used and builds up in the blood.
Low folate can be caused by eating disorders, alcoholism, liver disease, celiac disease, chrohn’s disease, malabsorption issues, or low vitamin C intake.
Some sources say excess folate is not a problem, but LeanMachine recommends a maximum intake of 1000 mcg daily from all sources.
One source is our Active Folate
Folate is famous for helping prevent neural tube defects in the developing foetus (e.g. Spina Bifida) when given to pregnant women.
Also helps with limb deformities, nerve problems, tumours and some birth defects.
Mothers should take Folate and B12 before, during and if breastfeeding, after pregnancy.
Because foetus problems from folate deficiency occur at just 3 weeks into the gestation period, this can be too late to start taking folate, so every woman of child-bearing age should supplement with folate.
Not so famous is the fact that most healthy people reaching 100 years of age are high in folate.
Folate benefits both sexes, helping to reduce levels of homocysteine (a marker of cardiovascular disease), especially in conjunction with B6 and B12.
Folic Acid and Folate are NOT the same thing.
Folate comes naturally from various foods such as spinach, asparagus, chickpeas, beans, and broccoli.
Folic Acid generally comes from cheap supplements.
Note: Many people have a defective MTHFR Gene which prevents the partial or full conversion from folate to the active form, MTHF ((6S)-5-MethylTetraHydroFolate) or Active Folate
This gene can be inherited or due to lifestyle, and up to 40% of the population have varying forms, producing very mild to very severe symptoms.
We can ask for a MTHFR (also known as MethylTetraHydroFolate Reductase) test, or simply use the Active Folate.
Low folate produces symptoms such as high homocysteine, hypothyroidism, lethargy, impaired cognitive function, and mood disorders.
LeanMachine recommends only the active form of Folate.
For those with the MTHFR issue, taking ordinary folate or folic acid will often make the problem worse.

NOTE: Out of range B-12 can mask testing results of Folate and vice versa, so BOTH need to be tested at the same time.

Homocysteine Testing

Range: 4 to 17 mcmol/L (normally higher in men than women)
Deficiencies in Folate and B12 cause high homocysteine, an amino acid.
High homocysteine can be caused by low folate and/or B12, too much alcohol, hypothyroidism, kidney disease, Alzheimer’s disease, homocystinuria, or cancers.
Low homocysteine can be caused by some medications, or excess folic acid, B12 or Niacin.
Read more about B-12, B-6, Active Folate and Homocysteine here.

Iron Testing

There are three different iron test ranges:
Serum Iron: Men: 12.5 to 31.3 nmol/L, Women: 8.9 to 26.8 mcmol/L
TIBC (Total Iron Binding Capacity) Men and Women: 45 to 76 mcmol/L.
Transferrin Saturation: Men 10% to 50%, Women 15% to 50%.
A test to see how well iron is metabolised in the body, often tested in conjunction with the Ferritin test – see below.
Out of range values can be diet, lead poisoning, liver, kidney, rheumatoid arthritis, hemochromotosis, anaemia, bleeding, supplement overdose.

Ferritin Testing

Normal Range: Men 18 to 270 mcg/L, Women 18 to 160 mcg/L, but some labs say 15 to 350 for men, 15 to 300 for women.
However, LeanMachine recommends levels between 20 and 80, preferably between 30 and 60. Anything outside this range can cause problems.
Ferritin is a protein that binds to iron in the blood, often tested in conjunction with the Iron test above.
High iron in the blood, pancreas or heart can cause many health problems, and eventually death.
High ferritin may be caused by:

  • hemochromotosis (over 1000 mcg/L)
  • Liver disease (cirrhosis or hepatitis)
  • Hodgkin’s disease
  • Leukemia
  • Infection
  • Arthritis
  • Lupus
  • Iron-rich diet
  • Receiving blood transfusions

Low ferritin can be caused by:

  • Bleeding (externally or internally)
  • Heavy menstrual periods
  • Pregnancy
  • Iron-deficient diet (such as vegan or vegetarian)
  • Blood donations
  • Loss through the skin (psoriasis)
  • Loss by excretion through the urine

High Iron/Ferritin has two basic treatments: Blood-letting (donating blood at the Red Cross), or taking
IP6 to chelate excess iron.
Many supplements can help chelate heavy metals from the body, but IP6 appears to be the ONLY way of effectively chelating iron with supplements.
Blood donations may be undesirable (e.g.religious reasons) or not allowed (e.g. if the donor has HIV or other disease, has recently been to an undesirable country, or is too old or otherwise ineligible).
Prescription drugs can be used, such as:

  • Deferoxamine (Desferal®), administered by subcutaneous (under the skin) infusion using a small portable pump, worn for 8-12 hours daily, usually while sleeping.
  • Deferasirox, either as:
    • Exjade®, a tablet dissolved in juice or water and taken orally once daily
    • Jadenu®, a tablet taken daily with water or other liquids
  • Deferiprone or L1 (Ferriprox™)

Side effects can be unpleasant or even damaging to health using prescription drugs. No all drugs are approved in all Countries.
IP6 appears to be the safest and most effective, and also helps treat cancer, diabetes, depression, osteoporosis, heart disease, and kidney stones.
Parkinson’s patients can improve because of reduction in excess iron, reducing neuronal degradation.

See LeanMachine’s article on Ferritin
Do NOT take iron supplements or use any method to increase or decrease iron without a full “Ferritin Study”, and watch for iron in multivitamins or other supplements.

HbA1C

Normal range: 4% to 5.6%
Pre-diabetes range: 5.7% to 6.4%
Diabetic range (controlled): 6.5% to 7%
Diabetic (uncontrolled): over 7%
HbA1C is a measure of how many glucose (sugar) molecules have “stuck” to red blood cells.
As red blood cells die in around 3 months, this gives doctors an insight into how well (or not) the patient’s blood glucose is under control,
as it effectively gives an average for the last 3 months, rather than a simple glucose test which only gives the result based on a moment in time when the blood was drawn.
As such, the HbA1C test SHOULD be given to everyone suspected of being diabetic or pre-diabetic, as this is the best screening method we have.
Unfortunately, our “smart” Australian Government only allows HbA1C testing in patients already diagnosed with diabetes, eliminating the best screening tool for diabetes available!
The reasoning behind this decision is to keep track of how many confirmed diabetics we have in Australia,
but surely it is more important to prevent diabetes in the first place by improving diet and lifestyle before real diabetes damage happens?

Note: People with iron deficiency anemia or other forms of anemia may have distorted results, giving higher than normal HbA1c when there is no high blood glucose.
Some other factors with people having unusual haemoglobin may have distorted high or low results.

Cholesterol Testing

Typical test is a “lipid study” which includes total cholesterol, LDL, HDL and triglycerides.

Total Cholesterol

This is a fairly useless test, but doctors wrongly prescribe statins for anyone with cholesterol over around 5.2 or who are over 50 years old or who have diabetes or heart conditions.
Statins cause depletion of the body’s co-Enzyme Q10, resulting in side-effects such as muscle pain, diabetes, osteoporosis, a weaker heart and more.
Patients on statins may have a slightly less chance of dying from cardiovascular issues, but an INCREASED risk of dying from all other causes.
The result is a poorer quality of life, and most people will not live one day longer.
For instance a woman on statins for over 2 years has double the risk of breast cancer, and other cancer risks are substantially increased.
Anyone on statins has a higher risk of cataracts, muscle and joint pain and many other conditions. Most of these problems are due to the low vitamin D levels caused by statins.
Statins also prevent the liver from producing cholesterol sulfate, which supplies oxygen, sulfur, cholesterol, energy and a healthy negative charge to every cell in the body.
CoQ10 and vitamin D3 supplements are essential for anyone taking statins.
Eat an organic apple a day instead of taking a statin and you may really “keep the doctor away”.

LDL – Low Density Lipoprotein

Desirable range under 2.0 mmol/L but not as important if HDL levels are high.
Often known as “bad” cholesterol, but has several important jobs in helping create hormones and other beneficial body components.
For decades, LDL has had a bad reputation as the bad cholesterol, when in fact high LDL levels are blamed simply because they are present whenever the body needs repairing,
for example an inflamed artery, where LDL goes to patch up the damage by helping to form a clot and preventing a rupture of the artery.
Obviously we need LDL for this and many other bodily functions, so high LDL is simply a warning sign of inflammation, and inflammation is better reduced by exercise and a healthier diet, rather than taking statin drugs,
which force the liver to produce less LDL, and NOT margarine (trans fat) which appears to reduce LDL but INCREASES deadly trans fats which cause cardiovascular disease and DOUBLE the risk of breast cancer
as well as most other cancers.

HDL – High Density Lipoprotein

Desirable range is over 2.0 mmol/L, with most labs stating the reference range 1.0 to 2.2 mmol/L.
Known as “good” cholesterol – High Density Lipoprotein
The main job of HDL is to assist in clearing LDL, triglycerides, trans fats, and other unwanted components from the blood by returning them to the liver for processing.
The liver then converts LDL to bile and most unwanted body products are then eliminated.
Without our “garbage collectors”, the human body would die in 24 hours.
A healthy diet free from sugar, processed foods, trans fats, etc is essential for adequate levels of HDL.
No prescription drug can raise HDL, only exercise and a healthy diet and supplements such as Niacin (Prolonged Release).
Many things can affect HDL test results such as pregnancy, serious illness, stress, accident, heart attack, etc so the patient should wait until 6 weeks after recovery for an accurate result.

VLDL (or VLDL-C) – Very Low-Density Lipoprotein Cholesterol

Desirable range: Less than 0.77 mmol/L or 30 mg/dL.
This is the only “bad” cholesterol, mainly when oxidised, generally caused by a bad diet of sugars and bad fats (Canola oil, margarine, etc).
Can be reported as part of a lipid study to determine risk of coronary heart disease, but not often asked for.
In fact, most regular labs do not test for this at all, instead estimating VLDL as a percentage of Triglycerides (see below).
Because a true test for VLDL is expensive and time-consuming, only a few research labs have the equipment and time to carry out a true test.
High levels of VLDL-C are believed to indicate the presence of lipoprotein remnants (intermediate particles on the pathway of conversion of VLDL to LDL).
High levels of VLDL slow the conversion of VLDL to LDL and may contribute to development of atherosclerosis and coronary heart disease.
Exercise, weight loss, and a healthy diet are the most effective ways to reduce triglycerides and in turn reduce VLDL.

Triglycerides

Healthy adults should have triglycerides less than 1.5 mmol/L.
The amount of fats (lipids) circulating in the bloodstream.
Exercise, weight loss, and a healthy diet are the most effective ways to reduce triglycerides.

CRP – C-Reactive Protein

Lab range: Less than 8mg/L, but 90% of all healthy people are below 3.0 and 99% below 12 mg/L, and a level below 0.8 mg/L is best.
CRP is a protein produced by the liver in response to inflammation.
High CRP (over 3mg per mL) can mean inflammation, infection, trauma and tissue necrosis, malignancies, or autoimmune disorders.
Often caused by inflammation in the arteries and veins, and can be a marker for possible cardiovascular disease.
High CRP can be caused by so many things that alone it cannot diagnose any particular disease, but only indicate further studies, and the test may be repeated after 2 weeks.
Obesity often causes elevated CRP levels, as fat cells produce signals for the liver to generate more CRP.
Doctors do not normally test for this in Australia (but do so commonly in the USA) so the patient should insist if there are other risk factors for cardiovascular disease
or other unexplained symptoms.
Low levels (below 1mg per mL) are considered normal.

Testing for Lyme Disease

Doctors have long insisted that Lyme Disease noes not exist in Australia.
This has been proven incorrect as there are countless Australians suffering from this disease, of which there are at least 14 known variants.
There is only one testing laboratory for Lyme Disease in Australia which has not been accredited, so most testing is carried out in the USA.
Lyme disease is generally transmitted through a tick bite, often going un-noticed, as a small tick can be no larger than a full stop on this page.
Tick bites are more common at latitudes North of Sydney, but can happen anywhere. People working or living among tall grass have a higher risk.
For more information, go to www.lymedisease.org.au

PSA (Protein Specific Antigen)

PSA testing has been used for a long time to check for prostate cancer.
However, this test does not always point to a problem, as many men have a high reading and no prostate cancer, while others have prostate cancer but a low PSA reading.
For men in a high-risk category – those on a bad diet, over 60 years of age, overweight, those with a family history of prostate cancer: should be tested on a regular basis.
Although a low PSA result is preferred, we aim to look for any change in the number between tests, say at least 3 months apart.
A significant increase in the value is more important than the actual number.
This PSA test has nothing to do with BPA (Benign Prostate Enlargement) which is not cancerous, but often affects quality of life by urgent and frequent urination.
Prostate cancer in men and breast and ovarian cancer in women are all known as estrogen-related cancers. Excess weight is a high risk factor, as every fat cell produces more estrogen, and the problem gets worse as men and women age, with ever-increasing weight gain bringing a higher cancer risk.

Thyroid Testing

The Hypothalamus gland releases TRH (thyrotropin-releasing hormone, which triggers the pituitary gland to release TSH (Thyroid Stimulating Hormone).
Most doctors only ask for a TSH (Thyroid Stimulating Hormone) test, but this test alone is insufficient for an accurate diagnosis.
Generally, doctors only order tests for other thyroid hormones if TSH (Thyroid Stimulating Hormone) is less than 0.5 mIU/L (hyperthyroidism, too much thyroid hormone)
or greater than 4.0 mIU/L (hypothyroidism, not enough thyroid hormone) when actually the top end of the range (hypothyroidism) should be 2.0 rather than 4.0
USA labs often say 3.0 as a top reading, but even this is too high, and some Australian labs say 4.5 is the top end which is way too high.
Note: Supplemental Biotin (part of the B-group vitamins) over 5 5mg daily should stop biotin supplementation at least 36 to 48 hours before blood collection.
These results are just a guide, and the doctor should evaluate results based on each individual’s health, symptoms, history and other factors, including results of other tests required.
Values outside those listed here may still be normal for each individual or laboratory.
Labs can measure TSH, total T4, FT4 (free T4), total T3, FT3 (free T3), T3U (uptake T3) FTI (Free Thyroxine Index), and T3R (Reverse T3) and others.
Almost all of the T4 in the blood is bound to a protein called thyroxine-binding globulin, leaving less than 1% unattached (free).
Total T4 blood tests can measure both bound and free T4. Free T4 affects body functions, but bound T4 does not.
Range for FT4 is approx 9 to 19 pmol/L but varies with the lab and the age of the patient.
FT4 (Free thyroxine) can be measured directly (FT4) or calculated as FTI (Free Thyroxine Index), which indicates the level of free T4 compared to bound T4.
Abnormal amounts of thyroxine-binding globulin is indicated by FTI.
Most T3 in the blood is also attached to thyroxine-binding globulin, and again, less than 1% of T3 is unattached.
Total T3 blood tests measure both bound and free T3 (triiodothyronine).
T3 is usually in much smaller amounts than T4, but T3 has a greater effect on the body’s metabolism than T4.
T4 is considered to be more of a “storage” thyroid hormone, where the body converts T4 to T3 as required.
This area is a huge subject and is discussed in greater detail here: Hyperthyroidism
Hypothyroidism is very common in older adults, and symptoms such as low energy can be attibuted to being a little overweight, or just an off day.
Thyroid tests are not part of the standard blood panel, but may be ordered if the patient reports fatigue and weight gain (hypothyroidism), or weight loss with nervousness or hyperactivity (hyperthyroidism).
Many doctors dismiss low or high test results if they are borderline, but these tests can indicate early thyroid problems.

TSH (Thyroid-stimulating hormone) Range 0.4 to 4.0 uIU/mL (same as mIU/L) Optimal range: 1.0 to 1.5 mIU/L
Total T4 (total thyroxine) Range 12 to 22 pmol/L (4.5 to 12.5 mg/dL) Optimal range: Top half
Free T4 (free thyroxine) Range 9 to 19 pmol/L (0.8-1.8 ng/dL) Optimal range: Top half
Total T3 (total triiodothyronine) Range 80 to 200 ng/dL Optimal range: Top half OK, very top quarter best
Free T3 (free triiodothyronine) Range 2.6 to 6.0 pmol/L (80-200 ng/dL or 2.3 to 4.2 pg/mL) Optimal range: Top half OK, very top quarter best
THBR (Thyroid hormone binding ratio) Range 0.9-1.1

A low TSH indicates hyperthyroidism.
If T3 and T4 shows below the minimum, hypothyroidism may be indicated.
If T3 and T4 is high, hyperthyroidism (over-active thyroid) may be indicated.
Hyperthyroidism is a common cause of gynecomastia in men because it increases the estrogen to testosterone ratio.

Copper Testing

Humans have efficient mechanisms to regulate copper stores, normally protecting from excess dietary copper levels.
Copper tests can help to diagnose some diseases such as Wilson’s disease or Menkes disease.
We should monitor total copper, free serum copper, 24-hour urine copper, and liver biopsy copper concentrations.
Some symptoms of excess copper are similar to those of a copper deficit, often making diagnosis difficult.
Serum ceruloplasmin is used to determine free serum copper.
Note that some infections or inflammation may temporarily increase copper levels.
Also, supplementation of zinc and/or magnesium will complete with copper for absorption, leading to a copper deficiency.

Copper reference ranges:
Free serum copper: 1.6-2.4 μmol/L (10-15μg/dL)
Total copper: 10-22 μmol/L (63.7-140.12 μg/dL)
Serum ceruloplasmin: 2.83-5.50 μmol/L (18-35 μg/dL)
24-hour urine copper 0.3-0.8 μmol (20-50 μg)
Liver copper 0.3-0.8 μmol/g of tissue (20-50 μg/g of tissue)

Normal copper values indicate normal dietary intake, physiology, absorption and excretion of copper.
Food sources of copper:
Many foods including seeds, organ meats, nuts, seafood, liver.
Copper is also found in the water supply.
Average daily copper intake in men: 1.54-1.70 mg/day, in women 1.13-1.18 mg/day.
The wide food sources make copper deficiency fairly rare.
Copper deficiency may be from:

  • Dietary insufficiency of copper (rare)
  • Malabsorption in the duodenum where most copper is absorbed.
  • Nephrotic syndrome
  • Those with Menkes disease (low serum copper, low serum ceruloplasmin, low liver biopsy levels)
  • Overcorrection of treatment for Wilson disease

High total copper may be from:

  • Ingesting too much copper
  • Eating acidic foods cooked in uncoated copper cookware
  • Poor excretion secondary to underdeveloped biliary systems, more common in infants
  • In Wilson’s disease, liver biopsy shows high levels of copper, the criterion for diagnosis
  • Elevated urinary copper (24-hour urine study) can also indicate Wilson disease
  • But low serum ceruloplasmin and serum copper are common in Wilson’s disease

Symptoms of copper deficiency include:

  • Fatigue and weakness
  • Frequent illness
  • Weak and brittle bones
  • Memory, learning and walking difficulty
  • Cold sensitivity
  • Pale skin
  • Premature grey hair
  • Low haemoglobin count
  • Too much Zinc and Magnesium supplements which fight Copper for the same cell receptors

Symptoms of excess copper include:

  • Mood swings, irritability, depression, fatigue
  • Excitation, difficulty focusing, feeling out of control
  • Vomiting, Hematemesis (vomiting of blood)
  • Hypotension (low blood pressure)
  • Melena (black “tarry” faeces)
  • Coma
  • Jaundice (yellowish pigmentation of the skin and/or whites of eyes)
  • Gastrointestinal distress
  • Those with glucose-6-phosphate deficiency may have greater risk of hematologic effects of copper
  • Hemolytic anemia from burn treatment with copper compounds (rare)

Chronic (long-term) copper exposure may damage the liver and kidneys.

Gene Testing

Testing for the BRCA1 and BRAC2 gene for Breast Cancer Risk

Angelina Jolie had a double masectomy as a result of a positive BRCA1 test, which is not the right thing to do.
Some Doctors claim that a positive result means a 95% chance of developing breast cancer.
In fact, the true figures are more like 80% increased risk, but the risk of breast cancer can be REDUCED by 80% or more in most women by:
– A healthy diet free of toxins, chemicals, processed foods, eating organic foods wherever possible.
– Elimination of sugar, especially fructose in the diet, including sugar hidden in processed foods.
– A teaspoon of Turmeric every day, preferably as a tea in a mug of hot water, with freshly ground black pepper (containing Bioperine) to substantially increase the release of cancer-fighting curcuminoids.
– Or alternatively, a Curcumin capsules, the active ingredient in turmeric).
– Adequate supplements of Vitamin D3,
Selenium and
Lycopene.
– Building the immune system by exercise and keeping off excess weight.
In other words, anyone with the BRCA1 gene can reduce their cancer risk to that of a normal person, and considerably less risk if the above recommendations are carried out from an early age and strictly adhered to.
If you still want the test, fine, but LeanMachine maintains that the above recommendations can help prevent ALL types of cancer, as well as maintaining a healthy heart, and preventing “modern” diseases like Alzheimer’s, MS, Parkinsons, Diabetes, etc.
Still want a double masectomy?
Remember that as soon as the surgeon starts cutting, any existing cancer cells will go into the bloodstream and circulate through every organ in the body.
Also we have the usual risks for any surgery – anaesthetics, infection, wrong drugs, side effects, incorrect dosage given, etc.

Testing Alzheimer’s gene

Yes, tests can now show if we have a high risk of Alzheimer’s Disease.
I did consider this myself. I watched my father slowly wither away and die from Alzheimer’s disease, deeply affecting my mother, friends, family and myself.
However, I declined to have the test because regardless of the outcome, the same diet I recommend for cancer and cardiovascular disease is also effective for reducing risk of Alzheimer’s.
The only extra thing to add is two to four tablespoons of Coconut Oil every day, because Alzheimer’s is often known as “Diabetes of the Brain” when glucose sometimes cannot get into the brain because the brain becomes “insulin resistant”.
The brain uses more glucose than the rest of the body, however, we can feed the brain with coconut oil effectively as it feeds the brain via a different pathway,
delaying or even eliminating the onset of Alzheimer’s.
Most Alzheimer’s patients will improve their symptoms on coconut oil. Countries with the most Junk food, e.g. the USA have an Alzheimers death rate of 24.8 per 100,000 while Phillipines, Malaysia, Maldives and other tropical countries where coconut oil is an important part of the diet, rates are around 0.2 per 100,000.
Of course, Alzheimers deaths are very much under-reported, as the patient normally dies from pneumonia or organ failure, which is often the cause reported on the death certificate.
Turmeric is also important as the active ingredient
Curcumin helps to dissolve amyloid plaques which are present in Alzheimer’s patients.
Drug companies have tried for years to get rid of amyloid plaques, but the have made no difference to Alzheimer’s, because the plaques are the body’s way of protecting neurons for damage caused by high blood glocose, high insulin, toxic metals like mercury, aluminium from vaccinations, food and the environment.
Wise old men are sometimes referred to as a “Sage” and the reason is simple – eating sage leaves every day can help halt Alzheimer’s.

Immunology

The range of tests below can help determine the risk or check the progress of treatment of many infections and autoimmune diseases.
Diagnosis can be complex, and should always be under the guidance on an Immunologist who specialises in this area.
Some tests also relate to allergies and these should be under the guidance of an Allergist.

RH – Rheumatoid Factor

Normal range is less than 14 IU/ml, the lower the better.
Results over 14 can indicate Rheumatoid Arthritis, or some other auto-inmmune disease, where
For further diagnosis of Rheumatoid Arthritis, the doctor may order a CCP (Cyclic Citrullinated Peptide Antibody) test.
Other tests may include a Synovial Fluid Analysis, where synovial fluid (which lubricates the joints) is drawn from the space between joints by a needle (not a blood test).

CCP (Cyclic Citrullinated Peptide Antibody)

This test helps diagnose Rheumatoid Arthritis, often confirming a diagnosis months before symptoms appear.

Immunoglobulins A, G and M

These are three tests associated with the immune system.
Immunoglobulins are protein molecules that contain antibody activity. They are produced by terminal cells of B-cell differentiation known as “plasma cells”.
There are five immunoglobulin (Ig) classes: IgG, IgM, IgA, IgD and IgE.
In normal serum, approximately 80% is IgG, 15% is IgA, 5% is IgM, 0.2% is IgD and a trace is IgE. IgD and IgE are not tested as often.
Total immunoglobulin levels are normally considered the total of the three most common: IgG + IgM + IgA, ignoring IgD and IgE.

IgG – Immunoglobulin G

Normal serum range (adults) varying between labs, is 62 to 140 g/L (620 to 1400 mg/dL in USA, some labs say 767 to 1,590 mg/dL).
Babies (Newborn to 5 months) is 10 to 33 g/L (100 to 334 mg/dL in USA), increasing with age to level out at adulthood (18 years +).
IgG is a major antibody type in blood, and can enter tissues and fight infection.
IgG has 4 forms, all providing most antibody-based immunity against invading pathogens.
IgG is also the only antibody that can cross the placenta to provide passive immunity to the fetus.
– High IgG – may indicate a chronic infection such as AIDS.
High IgG is found in IgG MGUS, IgG multiple myeloma, chronic hepatitis, and MS (multiple sclerosis).
With multiple myeloma (cancer of plasma cells in bone marrow), tumour cells make only the monoclonal type of IgG antibody (IgM), and reduced levels of IgG and IgA are found.
Other conditions make polyclonal IgG antibodies.
Electrophoresis is required (a lab technique) to separate macromolecules based on size. A negative charge is applied causing proteins to move towards a positive charge.
Used for both DNA and RNA analysis, and to differentiate the monoclonal from the polyclonal cells.
– Low IgG – can be found in patients with congenital deficiencies.
Low IgG occurs in Waldenstrom’s macroglobulinemia, where high IgM antibodies inhibit growth of B-cells that make IgG.
Low IgG can also indicate some types of leukemia and nephrotic syndrome (kidney damage).
Rarely, some people are born with insufficient IgG antibodies, and have a greater risk of infections.
Low IgG levels in adolescents or adults are classified as:

  • Mild to moderate 30 to 60 g/L (300 to 600 mg/dL)
  • Significant 10 to 29.9 g/L (100 to 299 mg/dL)
  • Profoundly reduced – under 10 g/L (under 100 mg/dL)

Adolescents and adults should have a total immunoglobulin (IgG + IgM + IgA) level greater than 60 g/L (600 mg/dL),
with confirmed normal antibody responses, to exclude humoral deficiency.
Total immunoglobulin levels of 40 to 60 g/L (400 to 600 mg/dL) or IgG levels of 20 to 40 g/L (200 to 400 mg/dL) may contain adequate amounts of antibody,
but this is unlikely if total immunoglobulin levels are under 40 g/L (400 mg/dL) or serum IgG levels are under 20 g/L (200 mg/dL).
A specialist should decide if a patient should start immunoglobulin replacement therapy, based on clinical history, physical findings, laboratory variables,
serum immunoglobulin levels, history of infections, concomitant diseases, antibody response to proteins and vaccines, radiographic studies, and pulmonary function tests.
Patients with profoundly or significantly reduced IgG levels and impaired antibody response are usually treated with replacement immunoglobulin
starting at 100 mg per kg of body weight per week, given either intravenously or subcutaneously.
Prophylactic antibiotics may also be needed in some patients.
Dosage and frequency is aimed to maintain serum IgG level greater than 60 g/L (600 mg/dL), and over 80 g/L (800 mg/dL) has potential to improve pulmonary outcome.
Serum IgG levels should be checked four to six month intervals to ensure that adequate trough levels are maintained.
Patients with mild-moderate reductions in IgG levels 30 to 60 g/L (300 to 600 mg/dL) and normal antibody responses generally do not require immunoglobulin replacement therapy,
but should be carefully monitored by a knowledgeable specialist.

IgA – Immunoglobulin A

Normal serum range (adults) is 8 to 35 g/L (80 to 350 mg/dL in USA, some labs say 61 – 356 mg/dL).
Babies 0 to 5 months: 0.7 to 3.7 g/L (7 to 37 mg/dL in USA), quickly increasing to age 2 to 4 years, then gradually increasing to stable adulthood (18+)
Sometimes a lumbar puncture is performed to test for IgA in Cerebrospinal Fluid (the fluid that bathes the brain and spinal cord) but this is uncommon as it has a higher risk.
Protects from infections of mucous membranes, typically in the lining of the mouth, airways, digestive tract, urogenital tract, preventing bacteria colonization.
Also found in fluids such as saliva, tears, and breast milk – see Secretory IgA below.
– High IgA – may indicate MGUS (IgA Monoclonal Gammopathy of Unknown Significance) or IgA multiple myeloma (cancer of plasma cells in bone marrow).
IgA may be higher in some autoimmune diseases, e.g. RA (rheumatoid arthritis) and SLE (Systemic Lupus Erythematosus), and in cirrhosis, chronic hepatitis and other liver disease.
– Low IgA – may indicate some types of leukemia, nephrotic syndrome (kidney damage), intestinal problems (enteropathy), and ataxia-telangiectasia (rare inherited disease
affecting muscle coordination). Increases risk of autoimmune disease, and risk of severe reactions to receiving blood products.

SIgA – Secretory IgA (Subclass of IgA)

Normal Range (saliva): 118 to 641 mg/L (118 – 641 µg/mL in USA)
Optimum Range (saliva): 130 to 471 mg/L (130 – 471 µg/mL in USA)
Normal range (fecal): 5.1 to 20.4 g/L (51 – 204 mg/dL in USA) (Genova Lab range).
​Secretory Immunoglobulin A (SIgA) is a subclass of Immunoglobulin A (IgA), tested in saliva or feces,
although also found in mucous secretions of tear glands, mammary glands, respiratory system, genito-urinary tract, and the gastrointestinal tract.
SIgA is not synthesized by mucosal epithelial cells or derived from blood but is produced by B-lymphocytes adjacent to the mucosal cells, then transported through the cell interiors, and released into the secretions from the cells.
SIgA protects the oral cavity, lungs, gut and other mucosal areas from invading pathogens.
SIgA has highest levels in the morning and lowest levels in the evening, but is dependant on flow rate.
IgA levels in saliva are affected by Concentrations normally decrease as flow rates increase, so flow rate is measured to express SIgA secretion as a function of time.
To maintain healthy SIgA levels, increase intake of Choline, EFA’s, glutathione, glycine, phosphatidylcholine, Vitamin C and zinc, all essential for SIgA production.

Anti tTg IgA, tTG Antibodies IgA, Tissue Transglutaminase (tTG), Tissue Transglutaminase Antibodies IgA

Serum test, a subclass of IgA, for monitoring adherence to gluten-free diet in patients with dermatitis herpetiformis (cutaneous manifestation of Coeliac disease) and celiac disease.
Reference Range:
Less than 4.0 U/mL (negative)
4.0 to 10.0 U/mL (weak positive)
Greater than 10.0 U/mL (positive)
These tests are not sensitive to age.
Usually tested along with IgG to help evaluate certain autoimmune conditions, commonly celiac disease.
If testing for celiac disease, the patient must eat gluten-containing foods up to 7 days before the test, otherwise no antibodies may be evident in the test result.
In celiac disease, the body produces IgA and IgG that attack tTG: immunoglobulin A (IgA) and immunoglobulin G (IgG).
Measuring the IgA form of tTG antibody in the blood is more useful in detecting celiac disease as tTG is made in the small intestine, where gluten causes inflammation and irritation in sensitive people.

IgM – Immunoglobulin M

Normal serum range (adults) is 0.45 to 2.5 g/L (45 to 250 mg/dL in USA).
Some labs say 0.37 to 2.86 g/L (37 to 286 g/dL).
Babies 0 to 5 months: 0.26 to 1.22 g/L (26 to 122 mg/dL in USA) gradually increasing to adult range (18+)
Women usually have higher IgM levels than men.
Often discovered by investigation of other conditions.
There are two types: Natural IgM and Immune IgM.
Natural IgM occurs in the body at all times, and Immune IgM responds to invaders in the body.
IgM is a large molecule and in non-specific in it’s attack role, and is the first line of defense to invaders, followed by IgG which is slower to respond,
but has a better targeting role for an individual invader.
Antibody measurements assist diagnosis of conditions, such as infections, immunodeficiency, autoimmune disease, and certain types of cancer.
Insufficient immunoglobulins increases susceptibility to infections. High immunoglobulins may indicate an overactive immune system (auto-immune condition).
Found mostly in blood and lymph fluid, and the first the body makes to fight new infections.
Expressed on the surface of B cells (monomer) and in secreted form (pentamer) with very high avidity (forms multiple binding sites with antigen).
Eliminates pathogens in early stage B-cell mediated (humoral) immunity before there is enough IgG.
– High IgM – may indicate a new infection, IgM MGUS, Waldenstrom’s macroglobulinemia, early viral hepatitis,
mononucleosis, rheumatoid arthritis, nephrotic syndrome (kidney damage), or parasite infection.
– Low IgM – occurs in multiple myeloma, some kinds of leukemia, and some inherited immune diseases.
Causes of Low IgM:

  • Smoking with alcohol consumption
  • Endurance exercise and over-training
  • Rheumatoid arthritis
  • Hashimoto’s thyroiditis
  • Lupus
  • Celiac disease
  • Crohn’s disease
  • Immune thrombocytopenia
  • Diabetes
  • Selective immunoglobulin M deficiency, a rare and sometimes hereditary disorder
  • Wiskott-Aldrich syndrome, a rare immune deficiency disorder
  • Lymphoid nodular hyperplasia
  • Leukemia

Smoking alone or alcohol consumption alone has little effect on IgM, but together they signigicantly reduce IgM.
Some patients have no symptoms, others may develop serious recurring infections.
Supplements shown to increase IgM:

  • Lycopene shown beneficial in human and animal studies, from red foods such as tomatoes and watermelon
  • Ginseng shown beneficial in animal studies
  • Astragalus shown beneficial in animal studies

Causes of High IgM:

  • Viral and/or bacterial infections
  • Some autoimmune disorders, including:
    • Type 1 diabetes
    • Multiple sclerosis
    • Primary biliary cirrhosis
  • Kidney damage, where proteins such as albumin and IgG are lost through urine (nephrotic syndrome), but serum IgM conversely increases
  • Hyper-immunoglobulin M syndromes, genetic immunodeficiency disorders with high IgM and low levels of other immunoglobulins
  • Louis–Bar syndrome (ataxia-telangiectasia), a rare genetic neurodegenerative disease
  • Cancers, such as multiple myeloma and Waldenstrom’s macroglobulinemia (a type of non-Hodgkin’s lymphoma)

Health Effects of High IgM:
1: Metabolic Syndrome, a condition characterized by three or more of: fat around the stomach, high blood pressure, high blood glucose, high triglycerides, and low HDL-C levels.
2: High IgM Levels Increase All-Cause Mortality Risk
To decrease IgM levels, work on resolving underlying health issue with a health care professional.

IgD – Immuglobin D

Normal range (adults) is 0.003 to 0.03 g/L (.3 to 3.0 mg/dL in USA). Some labs say anything less than 10 mg/dL is normal.
Many normal, healthy people have undetectable levels of IgD.
IgD fights bacteria, functioning as an antigen receptor on B cells that have not been exposed to antigens.
Shown to activate basophils and mast cells to produce antimicrobial factors.
– High IgD – can indicate IgD multiple myeloma, not as common as IgA or IgG multiple myeloma.
– Low or absent IgD – does not appear to increase infection risk. Not well-researched, so rarely tested.

IgE – Immuglobin E

Normal range (adults) is only a trace amount, .0002 to .02 g/L (or 200 to 20000 ug/L or 83 to 8333 U/mL) or (.002 to .2 mg/dL in USA).
Binds to allergens, triggers histamine release from basophils and mast cells.
Involved in allergic reactions, and protects from parasitic worms.
Frequently increased in parasitic infestations and atopic inviduals (with allergic hypersensitivity).
– High IgE – may indicate parasitic infection.
Also found in those with allergic reactions, asthma, atopic dermatitis, some cancers or certain autoimmune diseases.
Rarely, high IgE may mean multiple myeloma.
– Low IgE – may indicate ataxia-telangiectasia (rare inherited disease affecting muscle coordination).

Complement Tests

Nine major complement proteins, important for the innate immune system, are numbered C1 to C9.
These nine proteins help the body recognise foreign disease-causing cells. Certain health issues may cause deficiencies in these proteins or vice versa.
The numbering generally represents the order in which they react in a cascade of events (except C4).
There are three separate reaction pathways:
1. The the Classical activation pathway
2. The Alternative activation pathway
3. The Membrane attack pathway
Those with low early complement proteins (C1 to C4) are more prone to infections.
Low complement levels can also be a factor in development of autoimmune diseases.
Those with low late complement proteins (C5 to C9) can have a higher risk of infections caused by Neisseria (a type of bacteria that colonise mucosal surfaces).
Neisseria has two forms in humans, one causing ghonorrhea, the other causing bacterial meningitis which can lead to meningococcal septicaemia.
Some people inherit deficiencies in these proteins, some acquire deficiencies, others have these proteins “used up” by some disease, usually an autoimmune disease.
Normal immunology testing is only for C3 and C4, with other tests required if there appears to be an inherited or aquired deficiency in one or more complement proteins.
Reference range (those older than 16 years):Total hemolytic complement (CH50): 30 to 75 U/mL (41 to 90 hemolytic units).
Total complement (CH50) is used to screen for suspected complement deficiencies before ordering individual C1 to C9 complement tests,
as a deficiency of a single individual component of the complement cascade can result in an undetectable total complement level.
High levels of CH50 combined with high C3 and C4 indicate systemic inflammation, connective-tissue diseases including, but not limited to, SLE (systemic lupus erythematosus),
RA (rheumatoid arthritis), severe bacterial and viral infections, and others like cancer, diabetes mellitus, and myocardial infarction.
Also hypermetabolic states such as hyperthyroidism and pregnancy can be linked to high CH50 levels.
Low results may be a consequence of infectious or autoimmune processes.
Complement component activity varies. Those with rheumatoid arthritis can have high complement serum levels but low complement levels in joint fluid.
Normal C3 levels combined with undetectable C4 levels can indicate congenital C4 deficiency.
Congenital deficiencies of C1, C2 or C4 results in an inability to clear immune complexes.
Undetectable C1q levels combined with zero total complement (CH50) and normal C2, C3, and C4 suggests a congenital C1 deficiency, however inherited C1 deficiency is rare.
Absent (or low) C2 levels in the presence of normal C3 and C4 values are consistent with a C2 deficiency.
Low C2 levels with low C3 and C4 levels can indicate a complement-consumptive process such as infectious or autoimmune disease.
Low C2 and C4 levels with C3 levels may indicate C1-INH (C1 esterase inhibitor) deficiency.
Note: This test is different from C1q binding, which is an assay for circulating immune complexes.

C1, C1Q Complement Level

Reference range: 1.2 to 2.2 g/L (12 to 22 mg/dL USA)
Normally tested when Total Complement (CH50) level is undetectable, to diagnose congenital C1 deficiency.
Also to diagnose acquired deficiency of C1-INH (C1 Esterase Inhibitor).
Complement C1 is composed of 3 subunits: C1q, C1r, and C1s. C1q level indicates the amount of C1 present.
C1q recognises and binds to immunoglobulin complexed to antigen, initiating the complement cascade.
Like the more common C2 deficiency, C1 deficiency is associated with increased risk of immune complex disease such as SLE (systemic lupus erythematosus),
polymyositis, glomerulonephritis, and Henoch-Schonlein purpura.
Low C1 levels have also been reported in patients with abnormal immunoglobulin levels (Bruton’s and common variable hypogammaglobulinemia and severe combined immunodeficiency),
likely due to increased catabolism.

C2 Complement Level

Reference Range: 25 to 47 U/mL.
Normally tested when the patient with a low or absent (undetectable) hemolytic complement (CH50).
If the C2 result is under 15 U/mL, then C3, C4, and C2AG levels will be tested.
C2 deficiency is the most common inherited complement deficiency, although rare.
Homozygous (two of the same allele) C2 deficiency has an approximate prevalence ranging from 1 in 10,000 to 1 in 40,000.
Heterozygotes (specific genotypes with 1 each of different alleles) C2 deficiency has an approximate prevalence ranging from 1 in 50 to 1 in 100).
Around half of the homozygous patients are clinically normal, but in one third,
SLE (systemic lupus erythematosus) or discoid lupus erythematosus occurs.
People with both SLE and a deficient C2 level frequently have a normal anti-ds DNA titer.
Many have lupus-like skin lesions and photosensitivity, but immunofluorescence studies can fail to demonstrate immunoglobulin or complement
along the epidermal-dermal junction.
Diseases associated with deficient C2 level include dermatomyositis, glomerulonephritis, vasculitis, atrophodema, cold urticaria, inflammatory bowel disease
and recurrent infections.
Test results suggesting C2 deficiency include zero or undetectable hemolytic complement (CH50), with normal C3 and C4 values.

C3 Complement Level

Reference range Males: 8.8 to 25.2 g/L (88 to 252 mg/dL USA)
Reference range Females: 8.8 to 20.6 g/L (88 to 206 mg/dL USA)

C4 Complement Level

Reference range Males: 1.2 to 7.2 g/L (12 to 72 mg/dL USA)
Reference range Females: 1.3 to 7.5 g/L (13 to 75 mg/dL USA)
Complement C4 plays an important role in eliminating certain infections.
– High C4 – may indicate cancer or ulcerative colitis.
– Low C4 – may indicate:

  • Autoimmune disorders and collagen vascular diseases, e.g. lupus and rheumatoid arthritis
  • Bacterial infections
  • Hepatitis
  • Malnutrition
  • Rejection of a kidney transplant
  • Systemic lupus erythematosus (autoimmune disease affecting skin, joints, kidneys and other organs
  • Lupus nephritis (kidney disorder as a result of systemic lupus erythematosus
  • Cirrhosis (liver damage)
  • Glomerulonephritis (kidney disease)
  • Hereditary angioedema (rare but serious autoimmune disease, causes swelling in various body parts

C5 to C9 Complement Level

Reference range (C5): 29 to 53 U/ml.
Reference range (C6): 32 to 57 U/ml.
Reference range (C7): 36 to 60 U/ml.
Reference range (C8): 33 to 58 U/ml.
Reference range (C9): 37 to 61 U/ml.
Deficiencies of the late complement proteins (C5, C6, C7, C8, and C9) are unable to form the MAC (lytic membrane attack complex) and have increased susceptibility to neisserial infections.
Absent C5 to C9 levels with normal C3 and C4 levels are consistent with C5 deficiency.
Absent C5 to C9 levels with low C3 and C4 levels suggest complement consumption (Used up by an autoimmune disease).
Normal results indicate normal C5 to C9 levels and normal functional activity, although in rare cases, although C5 to C9 levels seem OK,
the protein can be non-functional, and further tests are required to determine correct function of C5 to C9.
See notes above under the heading Complements.
Additional notes re C7:
Most cases of C7 deficiency have neisserial infections, but rarely cases of SLE (Systemic Lupus Erythematosus), RA (Rheumatoid Arthritis),
scleroderma or pyoderma gangrenosum.
Additional notes re C9:
In the Japanese population, C9 deficiency is common, almost 1%.
Lytic activity of C9-deficient serum is decreased, but assembly of C5b-C8 complexes will result in a transmembrane channel with lytic activity,
although lytic activity is reduced.
Many C9-deficient patients show no symptoms, but may still present with invasive neisserial infections.

ANA – Anti-Nuclear Antibodies Screen

ANA tests identify serum antibodies that bind to autoantigens in cell nuclei.
Most of these antibodies are IgG, with IgM and IgA also sometimes detected.
The ELISA (Enzyme-Linked ImmunoSorbent Assay) method is mostly used.
Normal Range: Less than 1.0 U (or less than or equal to 1:40 dilution) is classed as a negative result.
Positive range:
1.1 to 2.9 U is weakly positive.
3.0 to 5.9 U is positive.
Greater than or equal to 6.0 U is highly positive.
A positive result normally indicates presence of an autoimmune disease where the body attacks connective tissue, and may indicate:

  • Mixed connective tissue disease
  • Drug-induced lupus erythematosus
  • Systemic lupus erythematosus
  • Sjögren syndrome
  • Scleroderma
  • Polymyositis-dermatomyositis
  • Rheumatoid arthritis

Some labs give results as 1:40 (good) while a result of 1:640 suggests an autoimmune condition. This is a measure of how much dilution of the blood specimen is required before the antibodies can no longer be observed.
Other tests will be required to diagnose a specific autoimmune condition.
Note that insufficient Vitamin D3 can cause some autoimmune conditions. Although Vitamin D3 increases immunity, it also moderates an immune system running out of control.

Allergy Testing

If the Eosinophil test (see under Haematology) is high, allergies may be the cause.
There are many allergy tests. Some are serum (blood) tests, and the sample may be tested in vitro exposed to a mixture of various allergens.
Allergens may be pollen, mould, animal fur or saliva, dust mites, birds, and various foods, the common culprits being:

  • Eggs
  • Peanuts
  • Cows Milk
  • Soy
  • Barley
  • Rice
  • Wheat (gluten)
  • Seafoods
  • Nuts
  • Antibiotics

When allergic reactions occur, levels of IgE are tested, and in some cases IgA

Anaphylactic Foods

These are foods which may cause enough swelling around the mouth, tongue and throat that breathing is difficult, and choking may occur.
Peanuts are perhaps the most famous food for causing breathing difficulties.
Usually overlooked by doctors: Lack of vitamin D, lack of sunlight, lack of very small exposure to these foods as a fetus or as a newborn are significant factors in these conditions.

Other Testing

The doctor may order many other types of tests, depending on results of previous tests combined with previous medical history, age, sex, current symptoms, family history, etc.

Sex Hormone Testing

Doctors can order an Androgen Study or Sex Hormone Profile, and may include any or all of the below tests and more:

Estrogens including E2 (estradiol), E1 (estrone), E3 (estriol)

E1 and E2 are the main active estrogens, as E3 is generally the pregnancy estrogen.
The enzyme aromatase converts testosterone to estradiol, and converts androstenedione to estrone.
Many other steroids can stimulate the estrogen receptor independent of aromatase.
This includes xenoestrogens such as BPA (Bisphenol A) and other plastics in the environment and unfortunately in the diet (microwave dinners, etc).
This is why LeanMachine recommends glass containers for all foods. BPA free plastics are just as bad. BPA has been replaced with BPS, and
although BPS is not taken up as much by estrogen receptors, once in the body it is very hard to excrete, so can easily build up to harmful levels.
E2 is mainly produced in ovaries and testes by aromatization of testosterone
High estrogen may come from estrogen secreting tumours, medications, exposure to BPA, pthalates and other toxins in plastics, from obesity (every fat cell can produce estrogens), and many other factors.
High estrogen may be a result of unusually high levels of testosterone, from testosterone replacement therapy or testicular tumour, which converts to estrogen by the enzyme aromatase.
Aromatase inhibitor drugs such as anastrozole (Arimidex), letrozole (Femara) and exemestane have largely replaced the older tamoxifen to help treat breast cancer in post-menopausal women.
Anti-estrogenic foods and supplements include cruciferous vegetables (broccoli, cauliflower brussel sprouts, cabbage), onions, garlic, healthy fats
(coconut oil, extra virgin olive oil, avocados, raw nuts), chrysin (passionflower),
DIM (diindolylmethane),
citrus bioflavonoids (diosmin, hesperidin,
rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin,
nobiletin, quercetin),
turmeric,
Curcumin,
fermented foods (sauerkraut, kimchi, fermented soy, fermented raw dairy, apple cider vinegar, kombucha).

Progesterone

I will omit the reference range here, as there are too many variables.
Progesterone levels are influenced by the time through the monthly cycle, age, pregnancy status, menstruating or post-menopusal, whether uterus and/or ovaries have been removed, if there are cysts on the ovaries, problems with the adrenal glands, and many other factors.
The test can help determine the cause of infertility, track ovulation, assist diagnosis of an ectopic or failing pregnancy, monitor pregnancy health, monitor progesterone replacement therapy, or assist diagnosis of abnormal uterine bleeding.
Men also have small amounts of progesterone.
If supplementation is recommended, see a doctor who can prescribe natural progesterone from a compounding chemist.
Most doctors will simply prescribe Progestin, an artificial and incomplete copy of real progesterone, with side effects perhaps worse than any benefit.
Women pregnant with twins, triplets, etc will usually have higher progesterone than those with a single fetus.
High progesterone levels can be seen sometimes with:

  • Some types of ovarian cysts
  • Non-viable pregnancies (molar pregnancies)
  • A rare type of ovarian cancer
  • Adrenal overproduction of progesterone
  • Adrenal cancer
  • CAM (Congenital Adrenal Hyperplasia)

Low progesterone levels can be associated with:

  • Toxemia late in pregnancy
  • Poor function of ovaries
  • Amenorrhea (Lack of menstruation)
  • Ectopic pregnancy
  • Fetal death or miscarriage

Testosterone

Required by men and women. Women have much less testosterone, but are more sensitive to it. Most testosterone is bound to SHBG (Sex Hormone Binding Globulin) which makes the molecule so large, it can no longer have any effect. Free Testosterone (not bound to SHBG) is the only effective testosterone.
Many labs will only measure total testosterone, and calculate free testosterone by measuring SHBG.
There are many causes of low testosterone, including disease, obesity, stress, insomnia and medications.
If blood tests show low testosterone and high LH, it may indicate a testicular problem in men, such as testicular failure or Klinefelter’s syndrome.
If blood tests show low testosterone and normal or low LH, it may indicate a problem with the pituitary gland.

SHBG (Sex Hormone Binding Globulin)

Attaches to other hormones to regulate their effectiveness when the body produces more hormones than we require.
This is a natural part of the self-regulation body system to prevent skyrocketing or insufficient hormones.

LH (Luteinizing Hormone)

Luteinizing hormone (LH), also called lutropin or lutrophin, British spelling luteinising hormone.
An acute rise of LH (“LH surge”) in women triggers ovulation and development of the corpus luteum (a hormone-secreting structure developed in an ovary after an ovum (egg) has been discharged, but degenerates after a few days unless pregnancy has begun.
LH is secreted by the gonadotropic cells in the anterior pituitary gland in the brain.
This signals the testes (in men) or the adrenals (in women) to produce testosterone.

DHEA

Often called the “Mother of all hormones” as levels can be a thousand times higher than other hormones.
DHEA is mainly made by the adrenal glands, and used to make testosterone and many other hormones.
Unusually high levels of DHEA can be caused by adrenal cancer or hyperplasia, and are aromatised into estrogen or other hormones.

Cortisol

Commonly called the “stress hormone”, or the “fight or flight hormone”.
We all need some cortisol, but long-term high cortisol, usually caused by chronic stress, is very bad for the body.
Cortisol levels vary considerably through the day, so testing is usually carried out at multiple intervals through the day.

Prolactin

Prolactin is a peptide hormone produced by the anterior pituitary gland in the brain.
Primarily associated with lactation, and vital in breast development during pregnancy and lactation.
Doctors test for prolactin in women with galactorrhea (unexplained milk secretion) or irregular menses or infertility, and in men with impaired sexual function and milk secretion.
If prolactin is high, a doctor will test thyroid function and ask first about other conditions and medications known to raise prolactin secretion.
Prolactin is downregulated by dopamine and is upregulated by estrogen.
Hyperprolactinaemia (abnormally high serum prolactin levels) may cause galactorrhea (production and spontaneous flow of breast milk)
and disruptions in the normal menstrual period in women, and hypogonadism, infertility and erectile dysfunction in men.
High levels of prolactin (sometimes due to a prolactin secreting tumour) inhibits the release of gonadotropin releasing hormone,
resulting in reduced LH (Luteinizing hormone, a gonadotropin) secretion, leading to reduced testosterone production.
Normal prolactin levels:
Women: Less than 500 mIU/L (20 ng/mL or µg/L)
Men: Less than 450 mI U/L (18 ng/mL or µg/L)

Beta-HCG

Also known as β-HCG, Human chorionic gonadotropin (HCG), quantitative blood pregnancy test, quantitative hCG blood test, quantitative serial beta-hCG test.
This Serum Quantitative test is the sum of human Chorionic Gonadotropin (hCG) plus the hCG beta-subunit, for early detection of pregnancy.
hCG consists of alpha (α) and beta (β) chains associated to the intact hormone.
The α-chains in all four of these glycoprotein hormones are virtually identical, while β-chains have greatly differing structures,
responsible for the respective specific hormonal functions.
Reference values change during pregnancy, and can double every 2 to 3 days.
Generally a level below 5 indicates no pregnancy, while a level over 25 confirms a pregnancy.
Results between 6 and 24 are a grey area, best re-tested later, or confirmed by ultrasound after 5 to 6 weeks from gestation.
Note: This is a much more accurate and useful test than hGC Urine tests available over the counter.

Range (mIU/mL)
Weeks of pregnancy is defined as completed weeks beginning with the start of the last menstruation phase.
Male 0−3
Female
nonpregnant 0−5
postmenopausal 0−8
pregnant
Weeks Gestation
3 6−71
4 10−750
5 217−7138
6 158−31,795
7 3697−163,563
8 32,065−149,571
9 63,803−151,410
10 46,509−186,977
12 27,832−210,612
14 13,950−62,530
15 12,039−70,971
16 9040−56,451
17 8175−55,868
18 8099−58,176

Levels are high if there is a testicular tumour in men, or pregnancy in women. Often used as a pregnancy test.

MSH (Melanocyte-Stimulating Hormone) Blood Test

MSH is an anti-inflammatory, regulatory hormone made in the hypothalamus, controlling hormone production, modulating the immune system and controlling nerve function.
Also caled: Alpha-Melanocyte-stimulating Hormone, α-MSH.
It is made when leptin is able to activate its receptor in the POMC (Proopio-MelanoCortin) pathway.
If the receptor is damaged by peripheral immune effects, such as the release of too many pro-inflammatory cytokines, then the receptor doesn’t work right and MSH isn’t made.
Leptin controls storage of fatty acids as fat, so MSH and leptin are a major source of interest for obesity control.
MSH controls hypothalamic production of melatonin and endorphins. Without MSH, deficiency creates chronic non-restful sleep and chronic increased perception of pain, respectively.
MSH deficiency causes chronic fatigue and chronic pain. MSH also controls many protective effects in the skin, gut and mucus membranes of the nose and lung.
MSH also controls the peripheral release of cytokines. When there is insufficient MSH, peripheral inflammatory effects are multiplied.
MSH also controls pituitary function, with 60% of MSH deficient patients not having enough antidiuretic hormone, causing patients to be constantly thirsty,
urinate frequently and often have unusual sensitivity to static electrical shocks.
40% of MSH deficient patients will not regulate male hormone production, and another 40% will not regulate proper control of ACTH (AdrenoCorticoTropic Hormone) and cortisol.

ACTH (AdrenoCorticoTropic Hormone)

Normal range: 9 to 52 pg/mL or 10 to 60 pg/mL depending on the lab.
Always tested early morning, as ACTH is highest 6 to 8 am and lowest around 11 pm. No ranges are specified for later in the day.
Normally tested in conjunction with a Cortisol test.
ACTH is a hormone produced in the anterior (front) pituitary gland in the brain, and regulates levels of cortisol (the steroid hormone),
which is released from the adrenal glands
Also known as:

  • Highly-sensitive ACTH
  • Corticotropin
  • Cosyntropin (drug form of ACTH)

Used to detect diseases associated with too much or too little cortisol, possibly caused by:

  • Adrenal or pituitary malfunction
  • Pituitary tumour
  • Adrenal tumour
  • Lung tumour

General

Some of the hormone tests above are blood tests, some are urine tests, some are saliva tests.
I have chosen not to discuss these tests in detail here, as it would fill an encyclopaedia.
These tests vary enormously with age, sex, pre or post menopause, time of the month for women, and so many other factors.
Doctors specialising in this field are best, as typical GP’s often do not have a great understanding of this complex problem.

Other general health tests

Body Mass Index (BMI)

BMI = weight (kg) divided by (height in metres squared).
Note: BMI does not allow for the amount of muscle compared to body fat, so a professional weight-lifter may have a BMI in the obese range, but still have a healthy body composition (more muscle than fat).

Underweight < 18.5 kg/m2
Normal 18.5 – 24.9 Caucasian
Overweight 25.0 – 29.9
Obesity class I 30.0 – 34.9
Obesity class II 35.0 – 39.9
Obesity class III (extreme, morbid) ≥ 40.0

 

Blood Pressure (Systolic / Diastolic)

At doctor’s office (average 5 measurements with lowest and highest readings discarded) < 140 / 90 mmHg
Ambulatory BP monitor < 130 / 85
With diabetes or stroke or cardiac risk < 130 / 80

Heart Rate (HR) or Pulse

Bradycardia < 60 beats per minute
Normal 60 – 80
Tachycardia > 100

Respiration Rate (RR)

Bradypnea < 12 breaths per minute
Normal (eupnea) 12 – 18
Tachypnea > 18

Body Temperature

Fever > 37.5 ° C
Normal 36.5 – 37.5 ° C (approximate)
Hypothermia < 35.0 ° C

Five Blood Tests for Everyone Over 50

Hepatitis C

Hepatitis C probably kills more people than any other virus, and 2014 data from the CDC in the USA shows hepatitis C–related deaths are at an all-time high.
Because this liver disease usually shows little or no symptoms, around half of those infected do not know they carry the virus.
Left untreated, Hepatitis C can lead to cirrhosis, liver cancer, and liver failure, all contributing to about 20,000 deaths in the USA alone.
A simple blood test can diagnose Hepatitis C, and if the test is positive, Hepatitis C is effectively treated before the liver damage becomes life-threatening.
For those born between 1945 and 1965, the USPSTF (U.S. Preventive Services Task Force) recommends a single hepatitis C test.
For those born before 1945 or after 1965, USPSTF reccomend testing only for high risk people, such as those
who had blood transfusions before 1992, injection drug users, or health care workers who have been stuck with a patient’s needle.

Blood glucose

For those overweight, or have have high blood pressure, or a family history of diabetes, there is a high risk for diabetes.
If blood glucose tests normal repeatedly, then once a year is often enough to repeat the test.
If pre-diabetes is diagnosed, immediate action is required to prevent the condition turning into full-blown diabetes.
The best way to prevent full-blown diabetes is to eliminate sugar, carbohydrates and processed foods from the diet.

Lipid panel

The lipid panel tests for LDL and HDL cholesterol and triglycerides.
See notes above.

STI (Sexually Transmitted Infections)

The doctor may ask if any sexual activity has changed (you or your partner).
Although STI’s are unusual among older adults, they are increasing.
Get tested if there are any doubts, as most STI’s can be easily treated and cleared up quickly.

Cancer Tests

Many tests are available, For example, abnormal levels of liver enzymes may indicate liver tumours before any symptoms are evident, allowing early surgery intervention, reducing other dangerous treatments and improving chance of recovery.

CA 15-3 (Cancer Antigen 15-3

This test is used mainly to monitor the treatment for metastatic (spreading) breast cancer.
CA 15-3 is a protein shed by tumour cells, often increased in breast cancer, indicating how the cancer has progressed or how the treatment has reduced the cancer.
CA 15-3 can be elevated in healthy people and in those with other cancers, so is not accurate enough to screen for early breast cancer.
Negative results do not mean there is no cancer, and positive results do not mean there is cancer.
CA 15-3 may be elevated by some other cancers, or by other non-cancerous conditions.
Related tests are Tumour markers, CEA, HER-2/neu, hormone receptor status.

<h3>HER-2, also called HER2/neu, is the acronym for Human Epidermal growth factor Receptor 2</h3>

Tests for HER-2:

FISH (Fluorescence In Situ Hybridization) test uses fluorescent probes, looking at the number of HER2 gene copies in a tumor cell.
More than two copies of the HER2 gene indicatesthat the cancer is HER2 positive.​

IHC (ImmunoHistoChemistry) test measures tumour production of the HER2 protein, ranked as 0, 1+, 2+, or 3+.
If results are 3+ the cancer is HER2-positive.
If the results are 2+, a FISH test determines if the cancer is HER2-positive.
If the HER 2 test is positive, it indicates that cancer can be treated with Herceptin (trastuzumab, an immune treatment), also Perjeta and Kadcyla.
A HER2 positive result also means that the cancer is most likely aggressive, so it is advised to start treatment as soon as possible to improve  survival and help prevent recurrence.

CA 19-9 (Cancer Antigen 19-9)

High CA 19-9 levels are usually caused by pancreatic cancer, but also by other cancers and by infections in the liver, gallbladder, and pancreas.
Related tests: Bilirubin, CEA, liver function tests, tumour markers

CA-125, also known as Cancer antigen 125

CA-125 is a protein produced by ovarian cancer cells, but also in some healthy women, and used as a marker for ovarian cancer.
CA-125 levels may be high in non-cancerous conditions such as pelvic inflammatory disease, excessive abdomen fluid (ascites), liver disease, pregnancy and menstruation.
Related tests: Tumour markers, BRCA-1 and BRCA-2

BRCA-1 and BRCA-2

See info above under the Gene Testing heading.

Calcitonin, also called Thyrocalcitonin

The Calcitonin test helps diagnose and/or monitor:

  • C-cell hyperplasia, a benign condition that may or may not progress to MTC
  • MTC (Medullary thyroid cancer), a malignant condition
  • Screen risk for MEN2 (multiple endocrine neoplasia type 2)

Age, pregnancy, lactation and food can influence calcitonin concentration in healthy people.
Reference ranges for some calcitonin chemiluminescent assays:
Males: Less than 8.8 pg/mL (ng/L)
Females: Less than 5.8 pg/mL (ng/L)
Athyroidal (without a functioning thyroid gland) people: Less than 0.5 pg/ml (ng/L)
Calcium Infusion test raises calcitonin levels.
Peak calcium infusion (IMMULITE 2000 calcitonin assay) test:
Males: Less than or equal to 130 pg/mL
Females: Less than or equal to 90 pg/mL
Normal range for peak calcitonin following calcium infusion is 100 to 200 ng/L
Specific reference intervals have not been established, so must be interpreted by the doctor along with other tests.
A high level of calcitonin should lead the doctor to perform a thyroid biopsy, scan and ultrasound to confirm the diagnosis.
About 25% of MTC cases relate to an inherited mutation in the RET gene, leading to MEN2.
Only 1 copy from either parent increases risk of MTC, occurring mostly in the 40 to 60 age group, but can occur at any age, more prevalent in women.

AFP (alpha-fetoprotein)

There are different AFP tests for different reasons, performed on a blood sample, urine sample, or amniotic fluid sample.
Other names for the test: Total AFP, MSAFP (Maternal Serum AFP), and Alpha-Fetoprotein-L3 percent (%)
Tested between the 14th and 22nd week of pregnancy as a screen for neural tube defects and chromosomal abnormalities.
Elevated AFP in maternal serum or amniotic fluid during pregnancy may indicate:

  • Spina Bifida
  • Anencephalia
  • Atresia of the oesophagus
  • Multiple pregnancy

Down Syndrome markers:
Maternal AFP levels, together with Beta-HCG, gestational age, maternal weight and other parameters, risk of Trisomy 21 (Down Syndrome) is calculated.
In Trosomy 21, maternal serum AFP concentration is decreased, while maternal serum Beta-HCG is about double the normal level,
and Pregnancy-Associated Plasma Protein A (PAPP-A) is reduced.
If a woman was screened for Down’s syndrome or open neural tube defects in a previous pregnancy,
the levels of the screening markers in that pregnancy can be used to adjust the marker levels in the current pregnancy.
Women with a false positive in one pregnancy is likely to have a false positive again in a subsequent pregnancy.
Twin / Down Syndrome markers:
Serum marker levels are raised in twin pregnancies, so twin pregnancies pose problems as one fetus may be affected and the other may not.
About 2% of pregnancies affected by Down’s syndrome are twins. If the twins are dizygotic (Fraternal, non-identical),
the risk of Down’s syndrome for each baby individually is the same as for a single baby (around 1 in 800 pregnancies).
If the twins are monozygotic (identical), the risk to both of having Down’s syndrome is also around 1 in 800.
A combination of Nuchal Translucency scanning and Serum screening may aid in risk assessment of Down’s syndrome for twin pregnancies.
Fetal Nuchal Translucency (FNT) screening uses ultrasound to measure size of the nuchal pad at the nape of the fetal neck,
performed between 11 weeks + 2 days and 14 weeks + 1 day.
Increased nuchal translucency reflects fetal heart failure, typically seen in any serious anomaly of the heart and great arteries,
and strongly associated with a chromosomal abnormality. In one study,
84% of karyotypically proven trisomy 21 fetuses had a nuchal translucency >3 mm at 10-13 weeks of gestation (as did 4.5% of chromosomally normal fetuses).
The greater the extent of FNT, the greater the risk of abnormality.
FNT is a straightforward test but will have a 20% false positive rate (FPR) if the thresholds are set to detect 85% (if used alone and maternal age adjusted).
Adding nasal bone screening during the same examination may increase sensitivity further and reduce the FPR.
One study concluded that an absent nasal bone should be considered as a highly predictive marker of Down’s syndrome.
Afro-Caribbean women have different marker levels than Caucasian women, heavier wome have different markers than lighter women, and those who skoke have different markers again.
Conclusion: These markers only pose a risk level, and do not guarantee a result one way or the other.

AFP also tests for cancer.
The Quantitative test, reporting the concentration of AFP in the sample, is the normal AFP test,
but a less expensive Qualitative test may be used sometimes, reporting only a normal or high concentration.
AFP is made by the liver and yolk sac of a fetus, and is the main protein in the first three months of development,
but decreases by age 1 to the very low levels found in adults.

However, AFP is a tumour marker for hepatocellular carcinoma (liver cancer), germ cell tumours (testicular, ovarian cancers),
also the rare nonseminomatous germ cell tumors usually found in the pineal gland of the brain.
AFP can also be elevated in some forms of biliary tract, stomach or pancreas cancers.
AFP may also elevated in Cirrhosis or chronic active hepatitis.

Reference range:
Non-pregnant adults, high blood levels, over 500 ng/ml (nanograms/milliliter) of AFP are seen in only a few situations, such as:

  • Hepatocellular carcinoma (HCC), a primary cancer of the liver
  • Germ cell tumors (a type of cancer of the testes and ovaries, such as embryonal carcinoma and yolk sac tumors)
  • Ataxia Telangiectasia, a severely disabling and rare genetic neurodegenerative disease

Moderately elevated values are found in:

  • Alcohol-mediated liver cirrhosis
  • Acute viral hepatitis
  • Carriers of HBsAg (surface antigen of the hepatitis B virus), indicating current hepatitis B infection

Amniotic Fluid AFP (alpha-fetoprotein)

Info to follow later…

Pregnancy Tests

See also AFP test above.

pregnancy-associated plasma protein A (PAPP-A)

To be advised…

Rare Tests

Protein C and Protein S

Other names for these tests:
– Protein C Antigen and/or Functional Blood Test
– Protein C, Functional or Antigen Test
– Protein S, Functional or Antigen Test
Protein C and Protein S are separate blood tests, often performed together. The tests are meant to assess either the functioning or the abundance of these proteins.
Protein C is an anticoagulant and anti-inflammatory enzyme. It requires both Protein S, a coenzyme, and Vitamin K to function.
It is similar to aspirin in its “blood-thinning” effects.
Protein C is made in the liver, while Protein S made in the inner (endotheliel) lining of blood vessels.
Both proteins circulate in the bloodstream.
Blood clotting is essential to minimise blood loss if injured, but it is regulated, because if the bood is too thin, we can bleed out and die,
but if blood is too thick, it can form clots when we do not need them, and restrict or block off blood supply, potentially causing loss of a limb or organ, and sometimes life.
About 1 in 300 people have protein C deficiency, which is classed as a hereditaty condition, although more people aquire it from taking Warfarin.
Most people with this deficiency have few problems with clotting, as long as diet and lifestyle factors are kept in a healthy manner, and any sudden clotting is attended to promptly.
If two people, both with Protein C deficiency, have offspring, then that child is more likely to have a very severe case of clotting.
Protein C is activated during the clotting process, to prevent too much clotting, by removing blood clotting factors,
and stimulating plasmin, a protein that degrades blood clots (fibrinolysis).
Deficiencies in these proteins can cause hypercoagulable blood (abnormal blood coagulation) and internal blood clotting (thrombosis).
There are several classifications, characterized by Protein C and S deficiencies:
– Type I is caused by insufficient quantity.
– Type II is caused by defective function.
– Type III (Protein S only) is caused by a low amount of active-form Protein S, but normal levels of total Protein S.
If there is a thrombotic (clotting) episode, then the test has to be performed only after a period of 10 days.
Low Levels of Protein C and Protein S may indicate:

  • Serious infections
  • Kidney disorder
  • Liver disorder
  • HIV
  • Pregnancy
  • Chronic high blood pressure (hypertension)
  • Disseminated intravascular coagulation (DIC)
  • Various cancers
  • Vitamin K deficiency

High Protein C and Protein S levels are rarely of concern.
Note: Test results are NOT to be interpreted as a “stand-alone” test.
Results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information.
Factors that may interfere with the results include surgery, oral contraceptives and chemotherapy.
Up to 15% of Caucasians carry a genetic mutation in a clotting factor that makes it resistant to Protein C’s effects, leading to similar symptoms as Protein C deficiency.
Tourniquet placement for extended periods of time can cause veins to pool with blood, altering Protein C and Protein S levels and affecting the test results.
Protein C and Protein S are being considered for use in therapy for individuals with hypercoagulation or Sepsis (whole-body inflammation).
LeanMachine advises finding a specialist experienced in these disorders, as these conditions can be easily mis-diagnosed.

More tests to follow here soon…

There are many more tests available, but the ones included here are among the most common.
To get accurate readings, be sure to follow instructions in preparing for tests.
We may be asked not to eat and to drink only water for anywhere from a few hours to 12 hours beforehand.
Follow these instructions, or results may be skewed, requiring additional tests or even unnecessary medications or procedures.
Remember that you have the right to ask questions!
No matter how busy the Doctor is, you are entitled to the information and explanation.
If the Doctor cannot provide it, ask the nurse. If you still cannot get a reasonable explanation, find another doctor!
This information is not meant to replace advice from the doctor, but to assist us to understand what the results mean, and allow us to ask the doctor any appropriate questions related to the test results, and understand the health, medication, treatment and prognosis implications.
And if the doctor says “All of your results are fine” then ask if any are “in range, but not optimal” and “what changes should I make to progress toward optimal results”.
Always get a printed copy of your results, and refer to this site to check if the doctor is really telling the truth, bluffing, or has no idea.

LeanMachine Supplements: Health Supplements, Body Building, Immunity, Diabetes, Cardiovascular, Weight Loss and more

Updated 6th September 2019, Copyright © 1999 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285

Reproduction by any means absolutely prohibited, however links to this site are allowed from other web sites after permission granted, email sales@leanmachine.com.au for link requests.

 

Posted by: | Posted on: August 8, 2019

Flu Shots During Pregnancy Failed to Lower the Risk of Fetal Death, Preterm Birth and Low Birth Weight

 … and For Some Outcomes Infants of Unvaccinated Moms Fared Better

© 6th August 2019 Children’s Health Defense, Inc. This work is reproduced and distributed with the permission of Children’s Health Defense, Inc.
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August 06, 2019

Reproduced from original article:
https://childrenshealthdefense.org/news/flu-shots-during-pregnancy-failed-to-lower-the-risk-of-fetal-death-preterm-birth-and-low-birth-weight/

By the Children’s Health Defense Team

Public health officials and doctors, ever more insistent that pregnant women get flu shots, are frustrated that fewer than four in ten American moms-to-be avail themselves of the recommendation. Policy-makers’ disappointment stems not just from their zeal to achieve the Healthy People 2020 goal of 80% coverage of pregnant women but also from their recognition that women who go along with vaccine recommendations during pregnancy are more acquiescent about vaccinating their newborn infants as well.

In their surprisingly frank conclusions, not only do the researchers report that influenza vaccination during pregnancy was ineffective in lowering risk for the four outcomes, but—ever so cautiously—they also note that the vaccinated infants fared worse.

Yet maternal worries about vaccine-related harm to the fetus are widespread and operate as a principal barrier to higher pregnancy vaccine uptake. Envisioning a day when “even more vaccines” will be added to the maternal vaccine schedule, researchers are studying how to improve uptake and design more persuasive “communication interventions.” Their messaging generally emphasizes a twofold rationale for prenatal flu shots. The first and primary stated aim is to prevent influenza in mothers and babies—but researchers also assert that by preventing such infections, they may be able to prevent unwanted fetal outcomes thought to be linked to influenza infection during pregnancy.

A research team out of South Africa has just published a paper examining the second rationale, comparing four outcomes—fetal death, low birth weight, small for gestational age birth and preterm birth—for infants whose mothers received flu shots or a placebo. In their surprisingly frank conclusions, not only do the researchers report that influenza vaccination during pregnancy was ineffective in lowering risk for the four outcomes, but—ever so cautiously—they also note that the vaccinated infants fared worse.

Unexpectedly (to the researchers), they also found that the average gestational age at birth was lower in the vaccinated versus placebo group—a statistically significant result indicative of a greater risk of preterm birth.

The study

The 2011–2012 South Africa study was one of three large double-blind, randomized, placebo-controlled trials of influenza vaccination during pregnancy funded by the Bill & Melinda Gates Foundation (BMGF). As originally described in 2014 in the New England Journal of Medicine, over 2,000 mothers received either trivalent inactivated influenza vaccines or placebo between 20 and 36 weeks of pregnancy—in other words, in their second or third (but not first) trimester of pregnancy. (In the U.S., which encourages flu shots during any trimester of pregnancy, studies have identified a heightened risk of autism in the children of women vaccinated during the first trimester.) The researchers followed up on fetal outcomes when the infants reached 24 weeks of age.

Overall, the investigators found “no significant vaccine efficacy” with respect to any of the fetal outcomes. Unexpectedly (to the researchers), they also found that the average gestational age at birth was lower in the vaccinated versus placebo group—a statistically significant result indicative of a greater risk of preterm birth.

Of note, the study used an inert saline placebo. This is unusual in the context of vaccine clinical trials, which nearly always compare one group that receives the vaccine of interest against another group that receives a different vaccine (called an “active comparator”). The use of active comparators can “increase the occurrence of harms in the comparator groups and thereby [mask] harms caused by the…vaccines” being studied. In contrast, an inert placebo enhances the likelihood of detecting differences between groups, if any are present.

Overall, the investigators found “no significant vaccine efficacy” with respect to any of the fetal outcomes. Unexpectedly (to the researchers), they also found that the average gestational age at birth was lower in the vaccinated versus placebo group—a statistically significant result indicative of a greater risk of preterm birth. Although most of the study’s other findings did not attain statistical significance, the pattern of results showed, in another writer’s words, tendencies that were “not reassuring.” Across all analyses, the percentages and rates of fetal death, preterm birth, low birth weight and small for gestational age birth were higher in the vaccine group than in the placebo group. Couching their conclusions with caveats, the authors explain:

[W]e found a slight, though non-significant decrease in the birth weight of infants in the vaccinated group…as well as a non-significant increase in fetal deaths among [influenza]-vaccinated mothers. […] We point this out only as a cautionary word and suggest this observation be explored carefully in larger studies of vaccine safety data bases.

… maternal hospitalizations for infections were “numerically higher” in the vaccinated group, as were severe neonatal infections.

Weak, inconsistent and biased evidence

In 2017, researchers who carried out a systematic review found that “comparative studies of adverse birth outcomes following maternal influenza disease are limited in quantity and have produced inconsistent findings.” In a 2019 paper, an Italian researcher agrees, arguing that it is inappropriate to recommend across-the-board influenza vaccination of all pregnant women in the absence of “strong and consistent” randomized clinical trial evidence—particularly if one also acknowledges that current evidence often exhibits bias. Making specific reference to the South Africa clinical trial, the author notes that the trial “was funded by BMGF and by public sponsors, with the principal investigator in financial relationships with the vaccine producer, and two authors with other influenza vaccine producers.”

The author describes other results from the South Africa trial that, while again not attaining statistical significance, “were not in the expected/hoped direction.” For example, maternal hospitalizations for infections were “numerically higher” in the vaccinated group, as were severe neonatal infections. Overall, the trial produced only “18 less influenza illnesses in vaccinated mothers and their children, to be weighted…against 9 more maternal hospitalization for any infection and 6 more neonatal hospitalization due to sepsis within 28 days of birth.”

In addition to the South Africa trial, the Italian author mentions several other randomized controlled trials (RCTs) in low-income countries that compared influenza vaccination during pregnancy against meningococcal or pneumococcal vaccination; even with an active comparator, the author suggests that these trials [hyperlinks added] do not support influenza vaccination during pregnancy:

The first and larger trial substantially disregarded an alarming excess of infant deaths and serious “presumed/neonatal infections” in the influenza vaccine group. Even in the other small RCT the fetal plus infant deaths were nonsignificantly higher in the influenza vaccine group. In a last large trial the tendency for miscarriage, stillbirth, congenital defects, and infant deaths at 0-6 months were not in favour of the vaccine group. These countries are not comparable to high-income ones, but one could expect that their poverty and demographic conditions would magnify the benefits of influenza vaccination, not the opposite.

A 2013 study that evaluated adverse pregnancy outcomes following influenza vaccination of pregnant women found that “low-risk” women (that is, women without medical complications or co-morbidity) who received the vaccine during the 2009–2011 influenza seasons had an increase in a composite measure of adverse outcomes (miscarriage, fetal demise, preterm birth and neonatal demise) compared to unvaccinated pregnant women—“even after adjusting for confounding factors.” Reluctant to accept the implications of their findings, the authors stated, “We do not believe that influenza vaccination causes adverse pregnancy outcomes in low-risk women; instead our findings likely represent the result of selection bias and residual confounding.”

The same kind of avoidance was apparent in a study that investigated risks for preterm delivery and birth defects following influenza vaccination in three consecutive seasons beginning in 2011. Although the researchers found that women in the vaccinated group had a shorter gestational duration and their infants had an elevated risk of a rare abdominal wall defect called omphalocele, the investigators concluded that their results were “generally reassuring” and that “[t]he few risks that were observed are compatible with chance.”

… no vaccines have ever been approved by the Food and Drug Administration (FDA) specifically for use during pregnancy to protect the infant.

A questionable policy

Researchers have speculated that influenza infection during pregnancy could be associated with adverse birth outcomes due to “mechanisms such as maternal fever and inflammation,” and they note that “[i]mmunological responses, such as elevated pro-inflammatory cytokine levels…are recognised as an important pathway to preterm birth.” What they generally do not acknowledge is that prenatal vaccination also introduces immune activation risks—and these risks remain scandalously understudied. Instead of bemoaning pregnant women’s “suboptimal” flu shot uptake—or dismissing the risks to a developing fetus from vaccinating the mother during pregnancy as “theoretical”—researchers and policy-makers should be putting their poorly supported pregnancy vaccination recommendations on hold. And members of the public should remember that no vaccines have ever been approved by the Food and Drug Administration (FDA) “specifically for use during pregnancy to protect the infant.”

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