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Mercury, Lean and Aluminium are the three worst heavy metals that have no place in the body, so we must reduce exposure to these for a healthy heart and brain.
What is Ferritin?
Ferritin is an intracellular (inside the cell) protein, in the shape of a hollow sphere. Ferritin stores iron by allowing entry of iron as ferric hydroxide phosphate complexes, and when the body needs iron, releases it as required.
Ferritin is produced by almost every living organism, from bacteria to plants, animals and humans.
In humans, ferritin is a buffer against iron deficiency and iron overload, and is found in most tissues as a cytosolic protein, which means it is inside the cytoplasm, the fluid inside each cell between the outer cell wall and the nucleus (The nucleus contains our DNA).
However, small amounts of ferritin are secreted into the serum (blood) where it works as a carrier of iron.
Plasma ferritin (in the blood) is also an indirect marker of the total amount of iron stored in the body. Serum ferritin levels are used to determine iron deficiency (anaemia) or iron overload.
Ferritin keeps iron in a soluble, non-toxic form. Free ferritin (not combined with iron) is called apoferritin.
Iron is the central atom of haemoglobin, which gives blood it’s red colour. 75% of the body’s iron is stored in haemoglobin, 10 to 20% in the protein ferritin, and the rest in the protein transferrin (the iron transport protein). Small amounts are found in myoglobin, cytochromes, as unbound serum iron and in body tissues.
Excess iron is usually stored in the Liver, Spleen and Bone Marrow, but also in the Pancreas, Joints, Skin, Pituitary, Adrenals, Thyroid, Heart and other organs.
The haemoglobin molecule is a very large molecule, almost identical to the Chlorophyll molecule in plants. Chlorophyll has a central atom of Magnesium, giving grass the green colour. Haemoglobin has Iron as the central atom, giving blood the red colour.
Chlorophyll is commonly best known for “cleansing of the blood”. Best sources are green leafy vegetables and wheatgrass.
Why do we need Iron?
If we have too little iron, we cannot make enough red blood cells, reducing our ability to carry oxygen to all parts of the body.
If we have too much iron, it can damage organs and contribute to cancer, heart disease, the entire cardiovascular system, especially the endothelial cells (the inside lining of all blood vessels), the kidneys and the liver.
Red blood cells are made in the bone marrow, and have a lifespan of around 4 months, when they die (the process called Necrosis).
The body makes around 200 billion new red blood cells every day, along with around 10 billion white cells and about 400 billion platelets every day, and around the same amount die every day.
Dead red blood cells are then broken down by Macrophages (special white blood cells) in the spleen. Some are disposed of in the digestive tract (which makes our poo brown) and parts of other cells are re-used. Haemoglobin is further broken down to salvage the iron, and excess iron is then stored in the liver.
Too much iron in the liver can cause Cirrhosis (Scar tissue replacing healthy cells).
We can have too much iron in some cases because the body does not know how to get rid of excess iron, it only knows how absorb it and to store it (using the transferrin protein).
Healthy red blood cells.
As red blood cells approach death, or are infected with a parasite or bacteria, or have a genetic defect, or are cancerous, the shape, size, smoothness and colour may be different.
How is Iron absorbed?
Iron in food is processed in the high-acid stomach, where it is changed into a form that allows it to be absorbed.
Absorption takes place mainly in the duodenum (part of the small intestine) and also to a lesser extent near the end of the small intestinal tract.
After absorption, iron is transported by the transferrin protein. A healthy body has the ability to absorb more iron when it is required, and absorb less when it is not required.
Haemoglobin, Hemoglobin or Hbg
Haemoglobin is a protein contained in red blood cells.
The job of haemoglobin is to carry oxygen from the lungs to all of the tissue in the body, then return carbon dioxide back to the lungs.
Haemoglobin is composed of four globulin chains (protein molecules) which are connected together, and in adults, haemoglobin contains two alpha-globulin chains and two beta-globulin chains.
In foetuses and infants, haemoglobin contains two alpha chains and two gamma chains, and during growth to an adult, gamma chains are slowly removed, replaced by beta chains to form adult haemoglobin.
Every globulin chain contains the heme molecule as the central structure, and iron is embedded in the heme molecule, essential for the transport of oxygen and carbon dioxide.
Haemoglobin is also essential to help maintain the shape of every red blood cells, which resemble a donut with a dished centre rather than a hole. Any abnormal shape can cause poor flow through blood vessels.
Anaemia is a condition where we do not have enough haemoglobin, which is usually, but not always, related to iron deficiency. It can be related to blood loss, from donating blood, from heavy menstrual bleeding, internal bleeding, blood loss from an injury, or insufficient iron in the diet (such as vegans or vegetarians).
IDA (Iron Deficiency Anaemia)
In most cases of anaemia, a blood test will reveal low haemoglobin and low ferritin, a result of iron deficiency, and the doctor will normally recommend iron supplementation or dietary changes or both.
ACD (Anaemia of Chronic Disease)
The body has a safety mechanism against harmful invaders such as cancer or bacteria. When sensing an invader, the body will move all iron it can from red blood cells back to ferritin, because all invaders need iron to thrive, and so does cancer. The body will leave just enough iron in haemoglobin for the cells to survive, but not enough to feed the invader.
We must NEVER take extra iron in cases of Chronic Disease, as we are only feeding the invader and doing more harm to our body.
ACD can be diagnosed by blood tests where we have low haemoglobin, but high ferritin. A C-Reactive Protein test (indicator of inflammation) is advised as well as ferritin if ACD is suspected.
When the disease clears up, the body will automatically return iron levels to normal.
Many doctors do not order ferritin tests when iron is low, resulting in the patient taking iron supplements which can cause damage or even death, so an accurate diagnosis of IDA or ACD is essential.
In some cases, IDA and ACD can occur at the same time, making diagnosis more difficult. One traditional test is Bone Marrow Aspiration with Iron Staining, but the Serum Transferrin Receptor test can help differentiate between IDA and ACD.
The Serum Transferrin Receptor test is significantly less affected by inflammation than the Serum Ferritin test. Results can be high in IDA and usually low in ACD, and the ratio of Serum Transferrin Receptor to the logarithim of Serum Ferritin Concentration is more helpful to distinguish ACD from IDA than is either individual test.
If the patient has any kidney damage (sometimes as a result of high iron) then it is possible to have high iron in the body tissues, while regular iron and ferritin tests results are normal or even low. In these cases, a specialist should supervise all testing.
Normally, the doctor will organise a “Ferritin Study”.
This includes the following tests:
- Serum Iron – how much iron is circulating in the blood, but this varies considerably and does not always mean a lot without also looking at the TIBC test below.
- Serum Transferrin – or TIBC (Total Iron Binding Capacity) or Transferrin Saturation. Iron is bound to transferrin (which is produced by the liver), and TIBC is a direct measure of transferrin. Iron overload is indicated with levels over 55% for males and 50% for females. Fasting is preferred for accuracy. Note that inflammation causes reduced transferrin levels
- Serum Ferritin – Indicates body iron stores. Typical lab results: Normal range 15 to 350 ug/L for men (some labs say up to 500ug/L), 15 – 300 ug/L for women, and varies depending on the lab and the method used, however LeanMachine says that these upper limits are way too high, and that anything over 80 ug/L indicates a possible iron overload condition, and anything below 20 ug/L indicates a possible iron deficiency. A healthy range is 20 to 80 ug/L, and the desirable range is 40 to 60 ug/L, but note that levels over 80 ug/L may be also be caused by liver disease, inflammation or cancer
- Soluble Transferrin Receptors – Transferrin receptors present on cell surfaces are responsible for internalization of transferrin resulting in intracellular release or iron. With low iron stores, expression of transferrin receptors increases, so the level of soluble transferrin receptors inversely reflects iron stores, and is unaffected by any inflammation, however high soluble transferrin receptors may also mean haemolysis (premature red cell death)
- A complete blood examination is also required to check Haemoglobin and other factors related to red blood cells, also liver and kidney function. Typical haemoglobin blood results 130g/L to 170g/L for adult males, 120g/L to 150g/L for adult females. For more info on these tests, see my article www.leanmachine.net.au/healthblog/blood-tests-how-to-read-the-results
- Further tests may include a Liver Biopsy, SQUID (Superconducting Quantum Interference Device), or MRI (Magnetic Resonance Imaging), but these are generally not required except for extreme cases
Note that these are Australian tests. In the USA, the results are in ng/ml (nanograms per millilitre), which is exactly the same as ug/L (micrograms per litre), with upper and lower numbers both divided by 1000, giving the same numerical result.
Types of dietary Iron
There are two main types of dietary iron, heme iron found in meat and other animal products, and non-heme iron found in plant products.
Generally, heme iron is better absorbed than non-heme iron, leaving vegans more at risk for iron insufficiency, however heme iron is also more dangerous for the body in high levels.
A healthy body self-regulates iron levels, by absorbing more iron when we need it, and absorbing less iron when we do not need it, but sometimes this regulation is upset or overloaded.
Factors affecting ferritin/iron levels
Menopausal women often (but not always) have low iron, especially if periods are heavy, while post-menopausal women usually have normal iron.
Pregnancy increases iron requirements, as the body needs to make around 30% more blood to support the developing foetus, requiring 30% more iron. The body will use the body’s stored iron, but if stored iron is insufficient, anaemia will occur. All pregnant women should get their iron and haemoglobin tests done at each trimester, especially if diet or other factors place them at risk.
Blood donors will often have low iron. Red Cross blood donation centres always test haemoglobin levels, and if too low (or even too high), that person cannot donate blood.
For an adult male, the normal range is 125g/L to 185g/L
For an adult woman, the normal range is 115g/L to 165g/L.
For donations of whole blood for males, the acceptable range is 120 to 165g/L for women, and 130 to 185g/L for men.
For donations of plasma and platelets, the acceptable range is 115 to 165g/L for women, and 125 to 185g/L for men.
If below 130 (male) or 120 (female), that person should build up their iron reserves and seek medical advice.
Bleeding in the GI (Gastro-Intestinal) tract can cause low iron, as in any other form of blood loss.
Bleeding because of haemorrhoids or anal fissures, or bleeding from cancer or inflammation in the small intestine, colon or stomach will cause low iron. If stools are dark, or blood in urine, or any unexplained abdomen pain, see your doctor.
Various foods and vitamins can increase or decrease iron absorption – see below.
Foods high in iron are also generally high in Vitamin B12, and both are required for correct ferritin/iron metabolism and healthy Red Blood Cells.
Vegetarians and vegans in particular are susceptible to low iron and B12, as both come mainly from animal products.
As we age, we tend to have reduced stomach acid, resulting in less B12 absorption, and to a lesser extent, reduced absorption of all other minerals, vitamins and other nutrients.
If we take supplemental iron, the body will absorb less iron from the diet.
If we have a low-iron diet, the body responds by absorbing more iron from anything available in food.
Sickle cell disease, thalassemia and haemochromatosis can all be inherited, and genetic testing for these and other genes affecting ferritin/iron is available.
Sickle Cell Anaemia
An inherited condition, mainly descendants of African people. A problem with the haemoglobin beta gene causes some red blood cells to become sickle-shaped, especially in hot, dry and intense exercise conditions.
25% of the population in West Africa have the sicklemia trait, also high in South and Central Americans, especially in Panama. Sometimes appears in Mediterranean countries like Italy, Greece, and Spain. Malaria may be a factor, as Indians, Middle Easterners (e.g. Arabs and Iranians), Native Americans, North Africans, and Turks have small but significant cases.
People with Sickle Cell Anemia actually have an advantage in some countries, as they are able to survive better if infected with Malaria. The “sickleing” of the red blood cells is promoted when the Malaria parasite enters, and the body’s own immune system is then able to identify and destroy the cell, along with the malaria parasite.
An inherited condition, originating in Mediterranean countries, causing weakening and destruction of red blood cells by mutant genes, affecting haemoglobin production. Similar to Sickle-Cell Anaemia.
Haemochromatosis (inherited iron overload disorder)
There is a genetic test for Haemochromatosis.
The test gives results for mutations C282Y and/or H63D of the HFE gene:
- Mutation not found (No Haemochromatosis)
- Heterozygous (which means one faulty gene) – Generally no or mild symptoms, bu bay be a “carrier” for children
- Homozygous (which means two faulty genes)
Children of a Mother and Father who are both carriers of one faulty gene have:
- 50% risk of inheriting one mutated HFE gene (and becoming a carrier)
- 25% risk of inheriting both mutated HFE genes (and at risk of excess iron absorption and symptoms of haemochromatosis)
- 25% risk of inheriting two normal genes, and will not be a carrier
Around 1 in 188 Australians have the HFE genotype C282Y mutation, the most dangerous kind, although 1 in 8 people are carriers for this gene. There are many primary (inherited) types, including:
- Type 1 – Classical haemochromatosis – Gene Mutation – HFE Genes C282Y and H63D, often with variations. C282Y is more serious.
- Type 2A – Juvenile haemochromatosis – HJV (Haemojuvelin), also known as RGMc and HFE2 Genes
- Type 2B – Hepcidin antimicrobial peptide (HAMP) or HFE2B Gene
- Type 3 – Gene Mutation – Transferrin receptor-2 (TFR2 or HFE3 Genes)
- Type 4 – African Iron Overload – Ferroportin (SLC11A3/SLC40A1 Genes)
- Neonatal haemochromatosis – unknown cause
- Acaeruloplasminaemia (very rare) – Caeruloplasmin
- Congenital atransferrinaemia (very rare) – Transferrin
- GRACILE syndrome (very rare) – BCS1L Gene
Also secondary types, which are not inherited, but acquired, especially if the patient has received many repeated blood transfusions.
- Severe chronic haemolysis – either intravascular haemolysis or ineffective erythropoiesis (haemolysis within the bone marrow)
- Excess iron from the diet
- Excess iron from supplements. Any supplements must be kept away from children. This is a common cause of childhood poisoning
Conditions may involve mutant genes inherited from both parents, so patients may have widely differing symptoms.
1 in 700 people with haemochromatosis have no mutation in the HFE gene. This is called Non-HFE haemochromatosis, due to mutations in other genes.
Symptoms of Low Ferritin/Iron
- Brittle Nails and/or spoon-shaped fingernails
- Intolerance to Cold
- Craving or Eating Non-Foods – dirt, hair, coins, etc (Pica)
- Irritibility, Loss of Concentration, Dizziness
- Pale appearance, especially membranes – inside of mouth and eyelids
- Increased infections
- RLS (Restless Leg Syndrome)
- Shortness of Breath
- Loss of Appetite
- Mouth Ulcers
- Dry Mouth and/or Sore Tongue
- Tachycardia (faster than normal heartbeat
- Arrhythmia (irregular heart beat)
- Loss of Consciousness (Syncope)
- Enlarged spleen
- Vitamin B12 deficiency
- Vitamin D3 deficiency
Symptoms – High Ferritin/Iron
- Chronic fatigue, tiredness, weakness
- Low levels of L-Glutathione
- Low levels of antioxidants
- Joint pain or aches
- Abdominal pain
- Diabetes mellitus (Type 2)
- Arrhythmia (irregular heart beat)
- Congestive heart failure
- Heart attack
- Changes in skin colour to bronze, ashen-grey or green
- Period is irregular or stops (women)
- Low Libido
- Hair loss
- Enlarged liver or spleen
- Impotence (men)
- Mood swings
- Low adrenal function
- Neurodegenerative disease
- High blood glucose
- High liver enzymes – ALT, AST, GGT
- High serum iron and serum ferritin
- Higher risk of cancer
- Weight Loss
How Much Iron do we Need?
Depends on who we are.
For post-menopausal women and healthy men, 8mg daily.
For menopausal women or blood donors, 18mg daily to replace iron in lost blood.
For pregnant women, 27mg daily for rapid growth and development.
Many breakfast cereals give all of menopausal women’s iron requirement, two-thirds the amount required for pregnancy, but double the amount for men and post-menopausal women, not counting intake from other meals.
Typically, there is a total of 3 to 4 grams of iron in the body. A normal diet should give most people enough iron, but vegans and vegetarians and blood donors will oten be lacking. People consuming large quantities of meat, especially liver meats, can reach iron overload withour knowing.
To INCREASE Ferritin/Iron
- Some breakfast cereals are fortified with extra iron
- Red meat – beef, lamb, kangaroo and organ meats, especially liver are rich in iron
- Low alcohol consumption (one drink daily with food) is fine, but overdoing it will cause liver damage
- Vitamin C (orange juice, fruit, supplements) will increase absorption of iron from food, up to 6 times greater absorption
- Avoid donating blood too often, or not at all if haemoglobin is less than 130 (men) or 120 (women)
- Build testosterone, by diet and exercise and/or supplementation to help build new red blood cells
- If vitamin B-12 and/or Folate is low, supplement or change diet
This is a dangerous condition, and if iron overload is suspected, a ferritin study is required. See above under “Blood Tests”.
To DECREASE Ferritin/Iron
Blood donation (therapeutic venesection) is usually the best method, and helps save lives of others.
If ineligible for Red Cross donations, private organisations can do this. Usually a ferritin reading of several hundred can be brought down to the normal range after half a dozen or so blood donations.
The only down side is that donations must be spread out over many months to allow the body to build new blood.
Next best option is using IP6 (Inositol Hexaphosphate) which can chelate excess iron from the body.
IP6 can help when the body cannot excrete excess ferritin/iron on it’s own, which can often happen. The body has limited capacity to remove iron, as it tries to always recycle iron.
Also the best alternative when blood donation is impossible, impracticable or ruled out for religious reasons.
IP6 has the added benefit of improving immunity.
More serious cases of iron overload can be treated with:
Deferoxamine (Desferal®) – administered via a needle from a pump attached to the body for 8 to 10 hours a day.
Deferasirox (Exjade®) – a tablet dissolved in a glass of water or juice, taken once a day.
Both methods can have undesirable side-effects, including hearing and vision loss, nausea, diarrhea, rash, kidney or liver injury, so LeanMachine recommends first using blood donation, IP6 and diet measures first.
- Donate Blood at the Red Cross. Reduces old blood recycling, leading to reduced iron stores which are used up in making new blood. May take several sessions over several months
- Take IP6 (Inositol Hexaphosphate)
- Eat cabbage every day (cooked, not raw). No scientific studies have been carried out with cabbage, but plenty of anecdotal evidence suggest it works, possibly by filling up on cabbage, the patient may not feel like red meat…
- Avoid red meat, and especially liver and other organ meats
- Drink green tea, black tea, oolong tea or coffee, and/or take a Green Tea Extract. The tannins in tea reduce iron absorption
- Take Vitamin E, Vitamin B-6, Curcumin
- Avoid taking too much Vitamin C, as this can increase iron absorption
- Do not cook in iron pots or pans, even if you have low iron, as metallic iron is bad for the body, regardless of the Ferritin status
- Avoid alcohol, especially wine with steak
- Never take iron supplements. If you take a multivitamin, or a “women’s health” or “men’s health” supplement, ensure it has no iron
- Never drink well water or bore water unless it has been tested free from iron (and other harmful metals)
- Take Astaxanthin – an extremely powerful antioxidant, 550 times better than Vitamin E. Will not chelate iron, but will help repair the damage
The Low-Iron Diet
Green Tea, black tea, oolong tea and coffee all contain tannins which inhibit iron absorption, so drinking these with a meal can help lower ferritin and iron levels.
Drinking milk with a meal also helps reduce iron absorption because of the calcium in milk that competes with iron for absorption.
Eat an egg every day, as eggs contain a compound that impairs absorption of iron. Avoid red meats, chicken and fish are better choices, much lower in iron than red meat. Better still, go vegetarian or vegan.
Calcium supplements can reduce iron absorption, but can also cause increased plaque in arteries, especially the Calcium Carbonate (ground limestone) used in cheap supplements, so should be avoided.
Breakfast cereals with whole grains contain some iron, but many are fortified with extra iron and should be avoided. Try an apple for breakfast instead and help keep the doctor away.
LeanMachine is a health researcher, not a doctor, and everyone should consult with their own health professional before taking any product to ensure there is no conflict with existing prescription medication.
LeanMachine has been researching nutrition and health since 2010 and has completed many relevant studies including:
Open2Study, Australia – Food, Nutrition and Your Health
RMIT University, Australia – Foundations of Psychology
Swinburne University of Technology, Australia – Chemistry – Building Blocks of the World
University of Washington, USA – Energy, Diet and Weight
Johns Hopkins Bloomberg School of Public Health, USA – Health Issues for Aging Populations
Johns Hopkins Bloomberg School of Public Health, USA – International Nutrition
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics I
Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics II
Johns Hopkins Bloomberg School of Public Health, USA – Principles of Human Nutrition
TUFTS University, USA – Nutrition and Medicine
TUFTS University, USA – Lipids/Cardiovascular Disease I and Lipids/Cardiovascular Disease II
Technical Learning College, USA – Western Herbology, Identification, Formulas
Bath University, England – Inside Cancer
WebMD Education – The Link Between Stroke and Atrial Fibrillation
WebMD Education – High Potassium: Causes and Reasons to Treat
Leiden University Medical Center, Netherlands – Anatomy of the Abdomen and Pelvis
MIT (Massachusetts Institute of Technology) – A Clinical Approach to the Human Brain
LeanMachine has now examined thousands of studies, journals and reports related to health and nutrition and this research is ongoing.
Updated 25th May 2020, Copyright © 1999-2020 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285
Reproduced from original article:
by: Natalie Robins, staff writer | December 3, 2019
(NaturalHealth365) Even if you try to eat a healthy, organic diet – you could be at risk for nutritional deficiencies without realizing it. In fact, the National Institutes of Health concluded that “the vast majority of people in both affluent and emerging industrialized countries do not reach even 75 percent of the RDAs for numerous trace minerals.”The importance of nutrient status (and deficiencies) cannot be overstated. For example, magnesium deficiency is widespread among Americans. One study, sponsored by the National Institutes of Health, shows that 68% of Americans are magnesium deficient and, some experts like Carolyn Dean, MD have been warning the public for years.
Editor’s note: Sea salt is an excellent way to get trace minerals into your diet. But, beware, most brands of sea salt are contaminated with microplastics. Click here to discover our top pick for sea salt.
What is the importance of trace minerals?
Some minerals, such as calcium, potassium, and phosphorus, are more common in food and in your body. Trace minerals, on the other hand, are essential minerals that you only need in trace amounts.
The following is a condensed look at certain minerals and their purpose in the body:
- Chromium is necessary for proper regulation of blood sugar and improves insulin sensitivity.
- Cobalt is present in vitamin B12 and it is necessary for generating healthy, red blood cells.
- Zinc allows for proper immune response, growth, antioxidant function and wound healing.
- Selenium is necessary for proper antioxidant function and liver detoxification. It is also essential for healthy muscles and hair.
- Iodine is necessary for your body to make thyroid hormone – which is involved in almost every process in your body including energy metabolism and temperature regulation.
Bottom line, trace minerals are essential to protect against common health issues, such as heart disease, diabetes, and cognitive decline. Without enough trace minerals, you’re also susceptible to contamination from heavy metals such as arsenic, mercury and lead.
Do NOT ignore the health dangers linked to toxic indoor air. These chemicals – the ‘off-gassing’ of paints, mattresses, carpets and other home/office building materials – increase your risk of headaches, dementia, heart disease and cancer.
Get the BEST indoor air purification system – at the LOWEST price, exclusively for NaturalHealth365 readers. I, personally use this system in my home AND office. Click HERE to order now – before the sale ends.
Why modern farming techniques MUST change to help save humanity
Why aren’t Americans getting enough trace minerals from their food supply? Obviously, we should be looking at soil content. Over the past century, the quality of our soil has been depleted by 85 percent – mainly due to modern methods of farming.
The agricultural sector is driven by crop yield, using every possible method to increase the number of pounds harvested. Intensive farming, combined with soil erosion, has resulted in soil with a lower mineral content. To make matters worse, chemical fertilizers are insufficient to replace the minerals needed for optimal health and poison the environment.
The singular focus on agricultural yield comes at the expense of nutritious food products and the nutritional status and health of Americans. Fruits and vegetables are now grown in soil with a lower nutrient content than in the past. A study in Canada found that tomatoes, spinach, cabbage, and lettuce have on average one-eighth the mineral content today than they did at the beginning of the 20th century.
The ocean provides a natural way to correct mineral deficiencies
If you just can’t depend on the produce section of your supermarket, how can you give your body the nutrients it needs to heal your body? The answer may lie in the ocean, which is rich in minerals.
They’re in their complete, non-denatured form, which is the form most beneficial (and recognizable) to the human body.
If you have the time and space, you can grow your own fruits and vegetables using ocean trace minerals to fertilize them. Another option is to eat seaweed, either as a food or as a supplement. Sea vegetable capsules are another source of minerals, and sea vegetables also contain health-promoting compounds such as fucoidan – which can help lower your risk for disease.
Of course, like with any other food, it’s important to know the source – to minimize the risk of consuming toxic chemicals in the food supply.
Editor’s note: If you want to avoid mineral deficiencies – I encourage you to investigate the health benefits of QuintEssential Optimum Mineralization 3.3. This super clean product is now available, in limited supply, at the NaturalHealth365 Store. And, yes, I’ve personally been using this high-quality product for over 4 years!
Sources for this article:
Reproduced from original article:
- Oxalic acid or oxalates are very tiny molecules that bind minerals like calcium and form crystals. It is found in a variety of seeds, nuts and many vegetables. It’s only two carbons and four oxygen molecules. It’s a highly reactive compound that is attracted to positively charged minerals
- Oxalates not only can cause kidney stones (calcium oxalate kidney stones) but also may be responsible for a wide variety of other health problems related to inflammation, auto-immunity, mitochondrial dysfunction, mineral balance, connective tissue integrity, urinary tract issues and poor gut function
- Oxalic acid can harm glandular function, connective tissue function, neurological function and the function of the tissues of excretion, particularly the kidneys and bladder
- Having a damaged gut lining will increase your absorption of oxalates. An inflamed or damaged gut lining is a very common problem, thanks to frequent antibiotic use and the presence of a number of chemicals in our food supply, including glyphosate. Other plant compounds such as phytates and lectins (such as gluten) can worsen gut health and exacerbate the impact of oxalates
- Tissue destruction, fibromyalgia and autoimmune diseases such as rheumatoid arthritis and lupus are all issues that can be related to oxalates
Sally Norton,1 who has studied nutrition and has a graduate degree in public health, is one of the leading experts on oxalate poisoning — a topic you don’t hear much about. Chances are you may never have heard about oxalates, or have any idea why they might matter.
As is often the case with experts in any health field, her expertise is an outgrowth of her personal struggles with health problems that didn’t respond to more conventional treatments, including healthy living (Norton was a vegetarian for 16 years).
“Like so many other people who are now discovering this, I was the kind of person who, no matter what I did, I could not create the vibrant robust health that I felt that I wanted, that I felt was intended for me to have.
It was just perpetual frustration, which is kind of amazing because the more you try to be healthy, the less it works — even when you’ve got a degree in nutrition from Cornell University and a degree in public health.
I worked in integrative medicine and knew all the holistic and complementary healing modalities … Here I was, the health expert who was not healthy …
The Vulvar Pain (VP) Foundation started educating people 25 years ago and making a big effort to get foods properly tested to know about oxalates in food because the story here is that we’re eating foods that are full of a toxin called oxalate …
We’re not paying attention to how this chemical’s affecting our physiology … [Oxalate] is a natural chemical that plants make, and we even make oxalate in our own metabolism.”
Chances are, if you have heard of oxalates, you’ve heard of them in relation to calcium oxalate kidney stones. A vast majority of the scientific information available on oxalate refers to this. However, while it certainly contributes to kidney stones, it can also have other detrimental health effects.
Interestingly, from the 1850s through the early 1900s, oxalate poisoning was well-recognized. Back then, it was referred to as oxalic acid diathesis. It was known to be a seasonal problem that got worse in the spring and summer, when fresh greens were available, when people’s oxalate consumption would go up.
Unfortunately, it has since gotten lost and left out of clinical science. As noted by Norton, there’s scientific evidence showing oxalic acid can harm glandular function, connective tissue function, neurological function and the function of excretion routes, particularly the kidneys.
Oxalic acid or oxalates are tiny molecules found in a variety of seeds, nuts and vegetables. It’s only two carbons and four oxygen molecules. It’s a highly reactive compound that is attracted to positively charged minerals. Norton explains:
“Calcium has a particular love of oxalate, and vice versa. The two of them seek each other out quite easily. We often see very abundantly the calcium oxalate form of oxalate. We see it in the plants. The plants form crystals and have the smaller individual ions and nanocrystals.
But they do form these bigger constructions, these kinds of plant pyramids, rocks and sticks and diamonds and things that the plants make, probably deliberately for many … plants are making use of oxalate for self-defense.
In the body, you’re going to see these other forms … A molecule that has less strong a bond — potassium oxalate, sodium oxalate and so on — those are the soluble forms. When you see oxalate in nature, you see the big calcium oxalate crystals — that’s the same thing that the kidney stone is made of. The major ingredient of the classic kidney stone is oxalate.
Unfortunately, in our parlance in medicine, we think of it as calcium … We just generalize to calcium because there are multiple types of calcium stones. But in the case of oxalate stones and oxalates causing calcification in the body, the oxalate part gets sort of dropped.
Medicine is not taught that you need the substrate to make a kidney stone. You need to provide enough oxalic acid or oxalate, soluble oxalate, the potassium oxalate, the sodium oxalates and so on. You can provide enough of that to perform this calcification in the kidneys and elsewhere in the body.
The plants that we’re eating have these oxalate crystals. The big ones just cause abrasion … They’re very small, but at the cellular level they’re quite big and abrasive. They just cause mechanical damage …
These soluble oxalates are the ones that easily — because they’re so tiny — pass through in between cells. Just with passive transport, we end up absorbing oxalates. The amount we absorb depends on a lot of factors, especially the health of our digestive tract.
Those of us with any inflammation in the digestive tract are more prone … to absorbing more of that soluble oxalate and even nanocrystals of calcium oxalate. At least 1% of calcium oxalate from food is also absorbed, in addition to the soluble oxalate.
But you see, soluble oxalate is not content being potassium oxalate. It would much rather be calcium oxalate, iron oxalate or magnesium oxalate. Right away, it starts grabbing minerals. It starts messing with mineral metabolism. It even can create bouts of acidosis.”
Conditions That Can Worsen Oxalates’ Impact
As mentioned, having a damaged gut lining will increase your absorption of oxalates. Most people, in fact, have damaged gut lining, thanks to a number of assaulting compounds and chemicals.
The presence of glyphosate in our food supply is one of these problematic compounds. If you’re not eating mostly organic food, you’re bound to be consuming glyphosate, which can wreak havoc on your gut function, as described in “Glyphosate: Pathways to Modern Diseases.”
Other gut-destroying exposures include frequent antibiotic use, which can lead to various forms of microbiome imbalance, including small intestinal bacterial overgrowth.
Some processed foods contain mucus-destroying emulsifiers. Even a number of naturally occurring plant compounds such as phytates and lectins (such as gluten) as well as the sharp oxalate microcrystals are trouble for gut health. These and other compounds found in foods can worsen gut inflammation and exacerbate the impact of oxalates by allowing oxalates easy entry into the blood stream.
Many of the foods that have become popularized in the modern diet are also high-oxalate foods, which means exposure is higher in general.
Examples of high-oxalate foods include potatoes, peanuts, nuts, spinach, beets, beet greens, chocolate, blackberries, kiwi, figs, black beans, buckwheat, quinoa and whole grains. Norton ate a lot of beans, soy, Swiss chard, and sweet potatoes when she was a vegetarian; these are all high oxalate foods. When she cut wheat and soy from her diet, sweet potatoes became a daily staple in her diet.
Eventually, she discovered the healing value of animal foods such as bone broth, but it took many years of painful disease before she made the connection between her arthritis and her favorite plant foods.
Nuts and seeds tend to contain high amounts of oxalates, so any seed is suspect if you’re sensitive. Pumpkin seeds, watermelon seeds, sunflower and flax are among the safest, as they contain lower amounts. Oils and fats, even when extracted from plants, are all low in oxalates.
“When you extract an oil or fat, you do not take with you the oxalates. It could have been from a peanut. The oil’s still low. Olives are pretty high, but olive oil’s low. It’s really simple. It’s not in the animal foods, and it’s not in the oils and fats. But it’s in most things that are seeds,” Norton says.
“It’s also in several green vegetables, mainly spinach, Swiss chard and beet greens. Those are really the bad ones. There are a couple of kales that are not so good.
Collards are kind of medium bad. The mixed greens that people like now … those baby mixes are loaded with little beet green leaves, little Swiss chard leaves, which are high [in] oxalates …
Certain fruits are really high: kiwi … clementine … Anjou pears, guava, figs, elderberries, apricots, blackberries, unripe avocados … Starfruit is so high it’s really dangerous.”
Signs and Symptoms of Oxalate Poisoning
Tissue destruction, fibromyalgia and autoimmune diseases such as rheumatoid arthritis and lupus are all issues that can be related to oxalates because oxalate in tissues trigger the inflammasome reactions of the body’s innate immune system.
“This reactive compound kind of trashes your basic building blocks of connective tissue,” Norton says. Oxalates also cause inflammation and interfere with your body’s natural healing and repair mechanisms that usually happen overnight while you sleep.
Needless to say, this can worsen a wide variety of ailments, and trigger just as many. Norton tells the story of her own health problems, and how she finally identified oxalates as the culprit causing them all.
“Glycoproteins are where the oxalates get stuck on cells. We tend to see oxalates keeping old injuries in place where you don’t fully recover all the way. That’s one symptom. You’ve got things that don’t completely clear up. For me, it was my feet … I was forced to leave school and go get these feet dealt with. I just could not function anymore.
I had surgery. I stayed out of school for four years because I wasn’t getting better … I was getting weird vulvar symptoms, arthritis, fatigue, difficulty focusing and cognitive problems. There are a lot of neurological neurotoxicity [effects from oxalate] that interfere with cognitive function and sleep.
Fast forward years later to 2009 when I learned about the Vulvar Pain Foundation and connected the bout of vulvar pain that I had to my diet. But it took me years more of flipping around with complete disability. I could no longer work … I basically was sofa-bound.
I had to have a hysterectomy … There was endometriosis in there. The ovaries were trashed … and I didn’t recover well from that. My endocrinologist sent me off to this sleep lab because he said, ‘You’re eating great. You look awesome by way of blood tests. But, obviously, you can’t read, function or exercise.’
I was surprised to see that my nervous system was so toxic that my brain was waking up 29 times an hour … I developed irritable bowel syndrome, and then eventually it turned into chronic constipation, which is very common amongst us oxalate-poisoned people.
Part of what’s going on there is those nerves and muscles are almost paralyzed. They’ve lost their control. Their sphincters aren’t working well. The muscle tone in the colon is not functioning well because of this constant stream of oxalates coming …
It looks like you have SIBO, or you probably do, because of all the antibiotics. Of course, … emulsifiers in our [processed] foods are eroding away the mucous layer. The mucous layer is another layer of protection that we’ve lost and increases our absorption of oxalates.”
Eventually, you may develop signs and symptoms that look very much like an autoimmune disease, such as rheumatoid arthritis or lupus. Norton realized she needed to get her gut healthy. The question was how. She’d already tried everything she could think of.
An experiment with a kiwi diet in 2013 finally made the oxalate issue hit home. Her arthritis flared up and she couldn’t sleep from the pain. At that point, it dawned on her that the kiwi — a high-oxalate fruit — and the arthritis were connected.
In about 10 days on an oxalate-free diet, all of her symptoms improved. Six months after that, her feet, which had never properly healed after her surgery, were completely fine.
Lectins and Oxalates Are a Problematic Mix
On a related note, lectins — another plant chemical — can also wreak havoc on your health, and Dr. Steven Gundry, author of “The Plant Paradox: The Hidden Dangers in ‘Healthy’ Foods That Cause Disease and Weight Gain,” strongly believes lectins are at play in many autoimmune diseases. Norton warns that together, lectins and oxalates can “gang up on you.”
“Plants have many other chemicals too. In my research, it looks like the main target of plant chemicals that are aggressive and harmful to us is the gut … Lectins are going to create that leaky damage and make you vulnerable to infection and absorbing oxalates.
Basically, these [oxalate] nanocrystals and ions are the most toxic forms. The bigger ones that later on you can see in … kidney stones, they’re actually less toxic than the little ones.
Nanocrystals are known to interfere with the charge on cells. They depolarize cell membranes and start disabling the functions of membranes, which means your mitochondria are not working. The oxalate slows down the mitochondrial ability to produce energy.
The nanocrystals of asbestos and oxalates have basically the same level of harm. It’s just that we don’t eat asbestos three times a day and call it health food.”
How Oxalates Contribute to Heart Failure
Oxalates can also contribute to heart arrhythmia, heart failure, endothelial disorders or generalized endothelial distress. Endothelial cells are the cells that line everything, including your vascular system. Oxalates floating around your vascular system can do considerable damage, causing irritation and injury to endothelial cells.
“You set up the conditions for vascular problems,” Norton says. “Oxalates are grabbing minerals. It’s taking calcium out of the blood … and probably other minerals as well. It also has the potential to take the place of the normal chelator that would hold iron in your transferrin …
What we see in people who are post-keto, where they’ve been doing the almond bread and spinach smoothies a lot (these are the kind of people who come to me — ex-vegans and ex-keto dieters), they are getting attacks of heart rates of 130, 150. They’re getting attacks of arrhythmia … A few of them get hospitalized and they’re seeing T-wave inversions … In this case, people have stopped eating the almond bread and the spinach smoothies …
Now the body is so ready to be done with the oxalate that’s gotten stuck in all these tissues that it starts removing too much at one time. Then you get localized acidosis. You get effects in the blood. You get effects in the heart rate.
We see this electrolyte disturbance, which involves continued wasting of potassium and other minerals. We have to keep re-adding these minerals. Also, it’s almost like tissue dehydration. I really like to push salt, potassium, calcium and magnesium to help manage this sort of flushing …
Diaphragm hiccups, by the way, are a bad sign … hiccups are a neurotoxicity symptom; the vagus nerve and the whole diaphragm is getting flipped up by being poisoned … The literature … shows that one of the last symptoms before the rats die or the humans die from oxalic acid poisoning is hiccups …”
Dental tartar and even dental caries are other signs of excessive oxalates. I struggled with chronic tartar buildup myself, until I learned it was related to oxalates. When clearing out oxalates you may also experience sinus pain. Your sinuses, eyes, teeth, jaw and salivary glands are all prone to oxalate buildup, as are your fingers, toes, feet and joints in general.
Do You Need to Ditch High-Oxalate Foods From Your Diet?
If you’re eating a lot of high-oxalate foods and are struggling with any kind of chronic health issue that doesn’t seem to respond to other sensible lifestyle changes and treatments, you’d be wise to give a low- or no-oxalate diet a try.
In my own case, I was eating a lot of sweet potatoes because they’re a good source of “healthy” carbs, but they are also loaded with oxalates. All potatoes are. There is no potato that’s not high in oxalates, so get rid of the potatoes. Norton offers the following advice:
“Turning this around, you have to make a decision that you’re willing to walk away from group think because everybody around you thinks that plants are so great and you need the spinach smoothies … If you’re willing to get some facts that are science-based, then I’ve got a lot of free information on my website.
The way I understand one of the major mechanisms is this something called a trigger-maintenance theory of the oxalate accumulation in the body. The body is really smart. It’s holding onto oxalates because it’s trying to protect you from that heart arrhythmia and all that vascular damage.
The nonvascular system … the body is willing to sacrifice in order to keep the vascular system well … If you’ve got too much oxalate in your blood, the other cells will deliberately hold on to it as a temporary deal …
The body’s holding on to oxalate is meant to be temporary. Every tissue that’s holding oxalate so wants it to be gone. You give it that opportunity when you stop eating oxalates. But there can be so much already onboard. If that stuff starts moving at the same time, you could release oxalate from tissues at a [toxic] level … We’ve got to be careful about how quickly and how we go about moving [oxalate out] …
There are simple things you can do to start lowering your oxalate. Pick the foods that you don’t need in your life and then eventually get down to the chocolate and cut that too …
On my website you can get a beginner’s guide2 that explains the basics and has a graphic that shows that your spinach smoothie is 20 times what your level of oxalate should be on a whole day’s intake. It has a list of the safe bet foods and the worst offender foods that you’ve got to start cutting back on and then eventually eliminating altogether …
The two main causes of disease are toxicity and nutrient deficiency. Oxalate is causing both … You’re losing both B-vitamins and minerals. It’s very toxic. It is a poison. It’s fundamentally messing with the basics of metabolism that allows tissue recovery, repair, [that] allows growth and flourishing.”
The Carnivore Elimination Diet
Norton has for several months now been doing the carnivore diet as described in “Health Effects of the Carnivore Diet,” which features my interview with Dr. Paul Saladino. Norton discusses her transition:
“I kept seeing allergy, intolerance and colon intolerance to a lot of plant foods. I had already worked my way down to eating lemon juice because citric acid … helps weaken in bonds of the [oxalate] crystals and make them quite easy to come apart.
Citric acid protects your kidneys and is a great way to dissolve kidney stones. A half a cup of lemon juice a day and a low-oxalate diet will help your kidneys release all this oxalate painlessly. You just start peeing out all your kidney problems without pain.
I was using a lot of lemon juice, four or so lemons a day, and eating coconut products and coconut water, often from fresh young coconuts, sometimes bottled or dried coconut, and very little else for like a year. It really does help the colon repair and recover. It’s such a nice elimination diet.
April 1, 2019, I dropped the lemons and a few more supplements I was taking, like vitamin E, and dropped the coconut products … I went full carnivore.
I, myself, think that the mitochondrial and metabolic damage that’s happening from the oxalates is also being promoted by PUFAs, the polyunsaturated fatty acids, which I did not have a lot in my diet.
But some of us still need some sugars in the diet to keep the mitochondria happy. I’m back to using some maple syrup and some mangoes and a little bit of carbs to keep my legs from cramping up with low muscle glycogen.
I still love a high-fat diet. I eat a lot of beef fat and pork fat. I really enjoy a meat-centered diet. I think it’s a fabulous elimination diet that can help us. Then figure out how to bring back into the diet, as much as you wish to, low-oxalate foods like lettuce, apples and coconut stuff and some rice, some blueberries … things that you may want in your diet.
There’s a whole lot of vegetables in the cabbage family that are low in oxalate, if your digestive tract likes them, [that] … have resistant starch in them and can be useful … Transitioning from a high-oxalate diet to a low-oxalate diet, maybe even all the way down to the carnivore-style elimination diet, needs to be gradual.
Because if you create a big microbiome die-off, you’re just going to feel sick from that as well. When the oxalates start coming out, that makes you feel sick. That’s another reason why we need supplements.”
Recommended Supplements for Oxalate Poisoning
Supplements recommended by Norton for those struggling with oxalate poisoning include calcium citrate, potassium citrate, magnesium citrate and potassium bicarbonate. These are all simple mineral salts that you can easily buy in bulk powders, which I recommend doing as readymade capsules contain amounts that are so low you’ll have to swallow a whole handful of pills to get the dosage you need.
If you dislike the taste of potassium bicarbonate (which has a flavor reminiscent of baking soda), you can purchase large empty capsules and make your own. Natural unprocessed salt (such as Himalayan salt) is another important “supplement.”
“Some people go through these waves of feeling ill again as their body starts pushing out oxalates because, when you stop eating oxalate, that doesn’t fix your oxalate problem in the short run, because you’re still full of oxalates …
It’s just that the acute phases that were occurring post-meal aren’t there anymore. But you’re going to have some other phases that are often circadian in nature where you have waves of not feeling good.
We want to be aware that some of what’s going on there is a form of acidosis … The combination of lemon juice and bicarbs — about a quarter cup of lemon juice and about one-eighth teaspoon of sodium bicarb and one-eighth teaspoon of potassium bicarb — makes a lovely Alka-Seltzer Gold, made with natural citric acid …”
Again, any changes you make, whether removing food items high in oxalate or adding supplements, make sure you do it slowly and incrementally. If you have a lot of oxalate in your body, too-rapid a change can shock your already fragile system, causing you to get worse rather than better.
Over time, work your way up to 1,200 milligrams of calcium citrate, about 400 to 500 mg of magnesium and 2,500 – 4,000 mg of potassium per day. The purpose of the calcium citrate is to help release oxalates from your tissues, so when looking for calcium citrate, make sure it does not have vitamin D in it, as the vitamin D encourages absorption of oxalates.
“The bicarb is wonderful because it’s not citric acid [which, for some, can irritate the gut]. It is also alkalizing, as is the citric acid and the minerals. All of this helps with alkalization. You’re replacing the minerals. You’re also providing it citric acid, which protects your kidneys and other tissues from oxalate accumulation and damage.
They’re really helpful. You want to take as much as you can tolerate, because the more the merrier when it comes to the minerals. I think general liquid mineral for a broad spectrum is really good, [and] taking [natural unprocessed] salt to help pull hydration and pull potassium back into the bones and the muscles.
A lot of us, if you get any muscle numbness, like fibromyalgia pains, that’s the potassium deficiency showing up in the muscles, where they end up in chronic rigor and you get hypoxia from the poor circulation going on there.
Once you’ve got enough potassium that will disappear completely in about five or six weeks … I have salt and potassium bicarb, potassium citrate always in my drinking water … I drink it all day long, all the time …”
If you don’t want to drink it throughout your day, Norton recommends taking a third of your daily dose at bedtime, as this is when your body is repairing and recovering and needs these nutrients most. Take another dose in the morning, and a third dose with a meal. An additional dose can be taken if you’re having an episode you think might be related to oxalate release.
Norton currently has a book in the works. Until then, the best place to find more information is her website, SallyKNorton.com. There you can find symptom lists, guidance on oxalate-elimination, low-oxalate recipes, free articles and additional interviews and talks,3 along with more details on the science behind oxalates’ devastating health effects.
For a quick look at your own intake of high oxalate foods and the signs of oxalate-related health issues, check out Sally’s Symptom and Exposure Inventory, HERE.
“If you work your way through the various tabs on my site, you will get a huge education there,” Norton says. “And then work your way … through my blog … There’s enough reading there. You’ll be busy for a while. That will really help a lot.”
Reproduced from original article:
Analysis by Dr. Joseph Mercola – Medically reviewed by Dr. Stephanie Seneff Fact Checked – October 09, 2019
- In a 2013 report, the American Society for Civil Engineers warned that most of the drinking water infrastructure across the U.S. is “nearing the end of its useful life,” yet little has been done to address the situation
- Recent media coverage make it clear that many toxic water incidences are covered up and hidden from the public, which at times has had lethal consequences
- In a September 25, 2019, report, the Office of Inspector General criticizes the EPA and water utilities around the country for their failure to provide consistent and accurate reporting of drinking water risks
- Aside from Flint, Michigan, and Newark, New Jersey, U.S. cities known to have exceeded EPA action limits for lead include Portland, Oregon; Pittsburgh, Pennsylvania; Providence, Rhode Island; Passaic, New Jersey and Tualatin Valley, Oregon
- Outbreaks of Legionnaires’ disease were covered up in Flint, Michigan, for at least two years, and in a Loma Linda, California, VA hospital, Legionella contamination was covered up in 2017, putting patients and staff at risk
Each year, red flags over toxic drinking water are raised across the U.S., with reasons varying from location to location. One major problem is aging water pipes, which have become an increasingly common source of toxic exposure.1
In a 2013 report,2 the American Society for Civil Engineers warned that most of the drinking water infrastructure across the nation is “nearing the end of its useful life,” yet little has been done to address our crumbling infrastructure in the years since.
Making matters worse, recent media coverage make it clear that many toxic water incidences are covered up and hidden from the public, which at times has had lethal consequences.
In short, if you’re counting on your local water utility to warn you about problems with your water supply, you could be placing your health at risk. Your best bet is to be proactive and make sure you filter your drinking water to the best of your ability, no matter where you live.
EPA Gets Failing Grade for Water Alerts
In a September 25, 2019, report,3,4 the Office of Inspector General (OIG) — which is part of the U.S. Environmental Protection Agency yet independent as it receives separate funding — criticizes the EPA and water utilities around the country for their failure to provide consistent and accurate reporting of drinking water risks. The OIG’s investigation identified several problems that could place public health at risk from contaminated water supplies, including the following:5
|Some primacy agencies (agencies with the primary responsibility for enforcing water regulations) are not consistently fulfilling their responsibility to enforce public notice requirements. Specifically, violations are not consistently reported and tracked, and public notices are not consistently issued.|
|The EPA’s oversight protocols do not cover all public notice requirements and as a result, some primacy agencies do not know whether the public water systems under their supervision are properly notifying consumers when safety violations occur.|
|All public water systems are not held to the identical compliance standards by the EPA and primacy agencies.|
|Primacy agencies use inconsistent methods to record violations and identify problems with public notice in the national drinking water database. Because the EPA’s information about public water systems’ compliance with public notice requirements is incomplete, the agency cannot properly monitor compliance.|
|The EPA’s public notice guidance given to primacy agencies and public water systems is out of date and does not fully reflect current regulations.|
|Public water systems lack accurate guidance about current tools available to provide public notices and may therefore “miss opportunities to efficiently inform consumers about drinking water problems.”|
According to the OIG report:6
“We made nine recommendations, including that the EPA require primacy agencies to comply with oversight requirements related to public notice and to follow data reporting requirements.
We also recommended that the agency update public notice guidance, define the acceptable methods and conditions under which notices can be delivered electronically, and improve public notice violation information in the national drinking water database.
The EPA provided acceptable corrective actions and estimated completion dates for six recommendations. Three recommendations are unresolved, with resolution efforts in progress, because the action official for these recommendations, the Deputy Administrator, did not respond to our draft report.”
The three recommendations that remain unresolved include:7
- Requiring EPA regional administrators to comply with public notice requirements.
- Requiring regional administrators to verify that primacy agencies within each region fully implement oversight of public notice responsibilities.
- Directing each region to require primacy agencies to adhere to requirements for accurate quarterly entry of public notice violation data into the Safe Drinking Water Information System.
Lead-Tainted Water Becoming Nationwide Concern
The fact that public warnings about water safety violations are not being consistently issued is a grave concern, seeing how prevalent water contamination around the U.S. has become.
A September 11, 2019, article8 in The Atlantic addresses the growing problem of lead-contaminated water. Aside from the well-publicized lead controversies in Flint, Michigan, and Newark, New Jersey, U.S. cities known to have exceeded EPA action limits for lead include Portland, Oregon; Pittsburgh, Pennsylvania; Providence, Rhode Island; Passaic, New Jersey and Tualatin Valley, Oregon.
In Newark, after lead levels were found to exceed federal limits three times in a row in 2018, the city issued water filters to some of its residents. Many others have been advised to drink bottled water ever since. However, evidence suggests the problem goes back far longer than 2018. As reported by The Atlantic:9
“A sample of Newark children under the age of 6 tested in 2016 found that about a quarter had measurable levels of lead in their blood. The following year, more than 22 percent of drinking-water samples tested in the city were found to have levels of lead exceeding the federal standard.”
Fortunately, Newark is now in the process of replacing all lead service lines. The same cannot be said for many other areas, though.
According to a Natural Resources Defense Council (NRDC) report10 issued in 2018, EPA data showed nearly 30 million Americans drank water that violated the EPA’s lead and copper thresholds between January 2015 and March 2018. Of those, an estimated 5.5 million were drinking water with lead levels exceeding the EPA’s action level for lead, set at 15 parts per billion (15 ppb).
Water Infrastructure Is Crumbling
As noted in the NRDC’s report, 15 ppb is not a “safe” level, but rather the level at which mandatory action is required to reduce the amount of lead in the water to avoid health complications. What’s more, the 15 ppb action level is based on adult metabolism, not children’s. In reality, no amount of lead is considered safe at any age, even by the EPA.
This goes right back to what I mentioned in the beginning — that drinking-water infrastructure in the U.S. is breaking down, and the appropriate investments have not been made to keep the infrastructure safe.
In Newark, many of the service lines are a century old! Water treatment technology is also lagging behind in many areas. As noted in The Atlantic:11
“According to [NRDC senior director for health programs, Erik] Olson, replacing all the lead service lines in the U.S. could cost $30 billion.
It’s a hefty-seeming sum, ‘but that’s the kind of investment that society made when these water systems were being built 100-plus years ago,’ he says. ‘We have been living off of the investments of our great-grandparents for decades.'”
Glyphosate Increases Lead in the Water
Historically, for five decades Flint, Michigan, had received its water from Detroit, originating in Lake Huron. However, in 2013, a tragic decision was made to temporarily supply the city with water from the Flint River as a cheaper alternative until a new water pipeline could be built coming directly from Lake Huron.
A study conducted by Marc Edwards of the Flint Water Study research group demonstrated that water from the Flint River was 19 times more corrosive to lead than the original water from Detroit.
The Flint River and its tributaries drain an agricultural region in Genesee and Saginaw counties. Soybeans, corn, wheat and hay are the main crops in Genesee county. Glyphosate is heavily used on these crops, both to control weeds and for dry-down at harvest.
Furthermore, Saginaw County is a major supplier of sugarbeets, which are genetically engineered to be Roundup Ready. The river has also served as an unofficial waste disposal site for refuse from local industries on its shores, including meat-packing plants and paper mills.
A likely reason why the water was so effective at stripping lead from the pipes is glyphosate contamination in the water. The first patent on glyphosate, issued in 1961, was for an application that involved its use as a descaling agent to clean mineral deposits from pipes and boilers in residential and commercial hot water systems.12
So, the glyphosate essentially chelated the lead out of the pipes and transferred it into the water. Once the water was consumed, the lead detached from the glyphosate in the person’s stomach, thus contributing to lead toxicity.
A recent Frontline documentary, “Flint’s Deadly Water,”13 points out that part of the issue was a water treatment plant that had been out of operation for many years and was not functioning properly when the water supply was first switched. Chlorine treatment is effective for breaking down glyphosate nonenzymatically, but was likely inadequate under the unusual circumstances of this water switch.
Water Fluoridation Also Worsens Lead Crisis
The increased presence of lead in drinking water is made all the worse by the fact that most areas are still adding fluoride to their municipal water supplies.14,15 Research shows fluoride actually leaches lead from water pipes with lead in them, thereby increasing the levels in the water. As reported by Fluoride Action Network in 2005:16
“A combination of chloramines and fluorosilicic acid, especially with extra amounts of ammonia, leaches lead from meters, solder and plumbing systems, according to Richard P. Maas, Ph.D. and Steven C. Patch Ph.D., co-directors of the Environmental Quality Institute at the University of North Carolina, Asheville.
Chloramine, a combination of chlorine and ammonia, is a water supply disinfectant. Fluorosilicic acid, the chemical used by over 91% of U.S. fluoridating communities, attempts to improve dental health in those who drink it … Maas said, ‘Tests showed lead levels three and four times higher in water with that combination of chemicals …’
These new findings may help explain earlier published, peer-reviewed research by Roger Masters, Ph.D. of Dartmouth College and Myron Coplan. Their studies show a link between water fluoridation status and elevated blood lead in children.
Elevated blood lead levels are linked to developmental delays in children under age six and fetuses. Lead can adversely affect almost every organ and system in the body. The most sensitive is the central nervous system, particularly in children. Lead also damages kidneys and the reproductive system.”
Legionnaires’ Disease Cover-Up in Flint
Recent media reports also warn that cases of Legionnaires’ disease — a severe and potentially lethal form of pneumonia — have been covered up, putting people’s health at serious risk. The Legionella bacterium thrives in warm, fresh water and is typically contracted by inhaling contaminated water vapor. It is not contagious between individuals.
In Flint, Michigan, a widespread outbreak of Legionnaires’ disease coincided with the city’s switch to Flint River water.17 In this case, residents were left in the dark not just about rising lead levels in their water, but also about the presence of this deadly bacterium.
As reported by PBS,18 it was one of the largest outbreaks of Legionnaires’ in U.S. history, killing 12 and sickening more than 90 people — at least those are the official numbers.
Unofficially, a review of death records suggests the death toll may have been far greater, as 115 residents died from pneumonia during the years of the outbreak, which lasted from 2014 through 2016. According to PBS:19
“Epidemiologists and infectious disease specialists told us that some of those people could have been Legionnaires’ disease cases that were left undiagnosed, untreated and, ultimately, uncounted.”
Disturbingly, NBC reports20 clusters of Legionnaires’ are still popping up in Flint to this day. Between January 1 and August 30, 2019, there were 16 confirmed cases.21 Flint isn’t the only place where the Legionella bacterium is wreaking havoc, though — and being covered up by authorities.
Legionnaires’ Is Being Covered Up Elsewhere as Well
A May 6, 2019, article22 in The Sun reported the U.S. Department of Veterans Affairs covered up Legionella contamination at a Loma Linda hospital in 2017, putting both patients and staff at grave risk.
Between 2017 and 2018, the hospital’s water supply tested positive for Legionella no less than 33 times, yet staff were not informed of the findings until June 2018, after a whistleblower complaint had been filed. As reported by The Sun:23
“Department of Veterans Affairs officials failed to notify physicians in 2017 about Legionella bacteria found at the VA Medical Center in Loma Linda, posing a public health danger and possibly causing at least one doctor to contract potentially fatal Legionnaires’ disease, according to a federal report …
The 26-page VA report substantiates a whistleblower complaint filed in February 2018 with the U.S. Office of Special Counsel by two doctors and six nurses at the Jerry L. Pettis Memorial VA who alleged hospital officials concealed the Legionella discovery for months …
The report acknowledges that, despite evidence in 2017 of Legionella in the Pettis Medical Center’s water system, VA officials didn’t develop an effective strategy to deal with the problem until contacted in June 2018 by the Southern California News Group.”
Similarly, a February 27, 2019, article24 in Georgia Health News reports cases of Legionnaires’ disease in Georgia have risen fourfold over the past decade — from 43 in 2008 to 189 in 2018 — and fivefold across the U.S. since 2000.
Surprisingly, 80% of the Georgia outbreaks have occurred in health care facilities. As for why the disease is on the rise across the U.S., no one knows, but it’s likely due to a convergence of factors, aging infrastructure being one of them.25
Filtering Your Water Is a Necessity
The take-home message from all of this is that you cannot rely on authorities to warn you about potential problems with your water. In many cases, public notices will be issued, but there are no guarantees.
Sometimes violations fall through the cracks due to poor documentation, reporting or oversight, as highlighted in the OIG report. Other times, violations are covered up — perhaps for political or financial reasons.
While lead and Legionella were the focus of this article, these are certainly not the only concerns. A 2017 analysis26 by the Environmental Working Group of water samples from nearly 50,000 water utilities in 50 states found 267 different kinds of toxins, including 93 linked to cancer and 63 suspected of causing developmental harm to children.
Among these hundreds of chemicals of concern, chromium-6 — an industrial chemical that is not regulated under the Safe Drinking Water Act — was found in drinking water in all 50 states at levels above those thought to pose a cancer risk, as was 1,4-dioxane, an industrial solvent. Nitrates, stemming from industrial agriculture, were also found at potentially risky levels.
Your safest bet is to take precautions to keep your family safe by installing a quality water filtration system in your home. As for the type of filtration system to get, there are a variety of options, most of which have both benefits and drawbacks.
Below are a few of the most common options. Allergy & Air’s 2016 article,27 “Water Filters: The Many Ways to Purify Your Drinking Water,” lists several more. Ideally, you want a filtration system that uses a combination of methods to remove contaminants, as this will ensure the removal of the widest variety of contaminants.
•Reverse osmosis (RO) — In addition to removing chlorine, inorganic and organic contaminants in your water, RO will also remove about 80% of fluoride and most disinfection byproducts (DPBs).
Drawbacks include the need for frequent cleaning to avoid bacterial growth. Your best alternative is to use a tankless RO system with a compressor. Cost is another factor, as you may need the assistance of a plumber to get the system up and running. RO will also remove many valuable minerals and trace elements along with harmful contaminants.
•Ion exchange — Ion exchange is designed to remove dissolved salts in the water, such as calcium. This system also softens the water and helps prevent the creation of scale buildup.
While advantages include a high flow rate and low maintenance cost, Sciencing points out the disadvantages, which include “calcium sulfate fouling, iron fouling, adsorption of organic matter, organic contamination from the resin, bacterial contamination and chlorine contamination.”28
•Granular carbon and carbon block filters — These are the most common types of countertop and undercounter water filters. Granular activated carbon is recognized by the EPA as the best available technology for the removal of organic chemicals like herbicides, pesticides and industrial chemicals.
One of its downsides is that the loose material inside can channel, meaning the water creates pathways through the carbon material, thereby escaping filtering.
Carbon block filters offer the same superior filtering ability but are compressed with the carbon medium in a solid form. This eliminates channeling and gives the ability to precisely combine multiple media in a sub-micron filter cartridge. By combining different media, the ability to selectively remove a wide range of contaminants can be achieved.
- 1 The Atlantic July 29, 2015
- 2 American Society for Civil Engineers 2013 Drinking Water Report
- 3 EPA.gov Report #19-P-0318, September 25, 2019
- 4, 5, 6 EPA.gov OIG Report Summary September 25, 2019 (PDF)
- 7 EPA.gov Report #19-P-0318, September 25, 2019, Full Report Page 27 (PDF)
- 8, 9, 11 The Atlantic September 11, 2019
- 10 NRDC.org September 14, 2018
- 12 Toy Arthur Dock Fon and Eugene H Uhing. Aminomethylenephosphinic acids, salts thereof, and process for their production. US Patent #160632A. 1961.
- 13 PBS Frontline, Flint’s Deadly Water 2019
- 14 PR Newswire February 11, 2016
- 15 Fluoridealert.com February 10, 2016
- 16 Fluoridealert.com May 23, 2005
- 17 Bioethics September 13, 2019
- 18, 19 PBS September 10, 2019
- 20 NBC25News May 10, 2019
- 21 MLive.com August 30, 2019
- 22, 23 The Sun May 6, 2019, updated June 28, 2019
- 24, 25 Georgia Health News February 27, 2019
- 26 EWG, State of American Drinking Water
- 27 Allergy & Air February 22, 2016
- 28 Sciencing April 25, 2017
Reproduced from original article:
(NaturalHealth365) Heart disease, the number one cause of mortality in the United States, is currently responsible for over 800,000 deaths a year. The primary risk factors for this potentially deadly condition are thought to include high blood pressure, lack of exercise, obesity, cigarette smoking and diabetes. But, with the results of a shocking study published in The Lancet, researchers are now pointing to another likely culprit – lead exposure.
Natural health experts have long warned that lead is a dangerous neurotoxin – for which there is no safe level of exposure. The startling study shows that lead exposure is not only associated with cardiovascular disease – but is responsible for the premature deaths of 412,000 (close to half a million!) Americans every year.
Even more troubling, the deaths were not linked to acute exposures, but to relatively low blood levels of lead.
Lead exposure is grossly ignored as a cause of heart disease and premature death
To conduct the large-scale, long-term population study, researchers examined the connection between lead concentrations, heart disease and all-cause mortality in over 14,000 adults.
The study was the first to examine the link between low-level lead exposure (characterized as under 5 micrograms per deciliter of blood) and cardiovascular disease. Keep in mind, according to Harvard Medical School, average levels for Americans currently hover around 1 ug/dL.
When the team specifically examined results for participants with blood lead levels between 1 ug/dL (the threshold of detection) and 5 ug/dL, they discovered that the risk of premature death increased substantially.
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In addition, the team found that people with higher lead levels (6.7 ug/dL) had a 70 percent greater risk of death from heart disease – when compared to those at the low end of the scale.
But that wasn’t all.
The researchers calculated that exposure to lead caused an 18 percent higher risk of dying from any cause, which translates to 412,000 deaths a year. Around 256,000 of those deaths occurred from heart disease, the team reported.
The researchers called low-level lead exposure an “important, but overlooked” risk factor for premature death in the U.S. – particularly for death from heart disease. The team stressed the importance of continuing efforts to reduce environmental lead exposure.
Additional studies support evidence of harm from lead exposure
Animal studies have shown that chronic, low-level lead exposure not only causes high blood pressure (a contributor to heart disease) but – by inactivating the body’s stores of beneficial nitric oxide – can also trigger atherosclerosis.
Lead exposure also contributes to atherosclerosis by inhibiting the repair of fragile, easily-damaged arterial linings. In addition, low-level lead exposure promoted the formation of blood clots – thereby directly raising risk of stroke and heart attack.
Not surprisingly, additional studies have reflected the findings of the Lancet study, linking higher concentrations of lead with high blood pressure, peripheral arterial disease and heart disease deaths.
Significantly, these findings directly contradict the prevailing wisdom concerning levels of lead at which harm can occur.
New research is causing experts to revamp views on low level exposure
Levels of 10 ug/dL to 25 ug/dL are considered proof positive that lead exposure is occurring – with levels of 25 ug/dL to 40 ug/dL considered “elevated.”
And, levels are considered “seriously elevated” between 40 ug/dL and 80 ug/dL, while levels over 80 ug/dL are “dangerously elevated” – with irreversible damage to health likely to occur.
As recently as 2013, only lead levels of 10 ug/dL, and above, were considered cause for concern. In fact, the National Toxicology Report previously described evidence linking blood lead levels under 10 ug/dL with heart disease-related mortality as “limited.”
Yet, participants in the recent study only had to average a modest 2.7 micrograms of lead per deciliter of blood to see their heart health and mortality affected – in a negative way.
Warning: Children are much more susceptible to damage
With smaller, still-developing systems, children under age six are much more susceptible than adults to the physical and mental effects of lead poisoning. Sadly, symptoms may not appear – in children and adults alike – until dangerous and damaging amounts of lead have already accumulated in the body.
Signs of lead exposure in children include learning difficulties, irritability, fatigue, weight loss, vomiting and diarrhea. Pica – a craving for non-edible substances, such as paint chips or dirt – can also indicate lead poisoning in children.
Lead exposure in newborns is manifested by premature birth, lower birth weight and slow growth.
Adults exposed to lead may experience high blood pressure, joint and muscle pain, headaches, impaired concentration and memory loss – along with reproductive problems such as reduced sperm count in men and miscarriage and premature birth in women.
Of course, very high levels of exposure to lead can cause seizures, unconsciousness and premature death.
Deteriorating lead paint in older homes threatens children’s health
While lead-based paints for homes, toys and furniture have been banned since 1978, lead exposure can still occur in older homes. The most common sources of lead poisoning in children are flakes of deteriorating lead-based paint – especially if the children nibble on them. Contaminated dust can also be released during home renovations in older buildings.
In addition, lead can persist in soil in the yards of older homes.
According to the New York State Department of Health, lead may still be found in batteries, solder pipes, pottery, bullets, roofing materials and various imported cosmetics and candies. Adults who perform renovations on older houses – particularly involving plumbing, roofing and painting – are at greater risk for exposure, as are those who work in auto shops and with batteries.
Worth noting: If lead exposure from an older home is a concern, the Harvard School of Public Health advises employing an EPA-certified lead abatement professional to replace lead plumbing pipes. You may also want to look into hiring a building biologist to ensure you’re living in a healthy home.
Vitamin C can effectively help to remove heavy metals from the body
Chelation, a protocol for treating lead exposure, features the use of edetate calcium disodium, or EDTA. This compound binds with and removes heavy metals, including lead, iron and copper.
There is now clinical evidence that vitamin C, a potent antioxidant, can potentiate and enhance the detoxifying effect of chelating agents.
In a recent study published in Life Sciences, researchers found that EDTA and vitamin C together are more than twice as effective as either substance given alone. The team noted that the combination is particularly effective in removing lead from the central nervous system.
And, optimal levels of vitamin C can protect against high lead levels.
In a study conducted by University of California at San Francisco and published in the prestigious Journal of the American Medical Association, the researchers found a direct association between high levels of vitamin C and lower blood levels of lead.
Adults had blood levels reduced by 68 percent with higher vitamin C intake, while children with higher vitamin C intake fared even better. Researchers found that those in the top one-third of vitamin C levels displayed an 89 percent lowered incidence of lead toxicity.
It is important to consume enough vitamin C to protect against the effects of lead exposure – whether through vitamin C-rich foods (such as citrus fruits, bell peppers and Brussels sprouts) or supplements.
Natural health experts note that at least 1,000 mg of vitamin C a day is required to reduce lead levels and enjoy other benefits – including stronger overall immune function.
Sources for this article include:
Written by Brenton Wight, Health Researcher, LeanMachine.
Copyright © 1999-2020 Brenton Wight, LeanMachine.
Updated 19th November 2020
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.
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”.
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
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.
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, 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 can spread, causing a lot of damage, but are easily treated if diagnosed with a blood test.
Can be caused by many things including internal bleeding, kidney disease, malnutrition, vegan diet, etc but can usually be simply treated.
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
- 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 own 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.
- cmm3 – cells per cubic millimeter
- g/L – grams per liter
- g/dL – grams per deciliter (same as 1/10 of g/L [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:
- Blood loss, internal or external
- Bone marrow failure
- Iron deficiency
- Copper deficiency
- Multiple myeloma (cancer of plasma cells in bone marrow)
- 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
- 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
- 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
- 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:
- Blood loss
- Low RBC
- Bone marrow failure
- Abnormal breakdown of Red Blood Cells
- Increased production of WBC
- Adrenal dysfunction
- Low thymus function
- Multiple myeloma (cancer of plasma cells in bone marrow)
- RA (rheumatoid arthritis
High PCV/HCT may indicate:
- 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
- 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
- Liver disease
- 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)
- 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
- 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:
- 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:
- 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.
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:
- 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)
- 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
- 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)
- 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
- Aplastic Anemia
- Systemic Lupus Erythematosus (SLE)
- Hodgkin’s Lymphoma
- Radiation and Chemotherapy
Some inherited causes of Low Lymphocyte Count:
- Wiskott–Aldrich syndrome
- 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 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.
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
- 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
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:
- 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
- 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
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
- Swollen ankles and fingers
- Worse menopause symptoms
- Asthma drugs (such as Abuterol)
- 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.
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).
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:
Calcium, essential for the proper functioning of muscles, nerves, and heart, also for blood clotting and bone formation.
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.
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.
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.
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.
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)
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)
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.
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.
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:
- Peg-interferon + ribavirin
- 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
- Recent surgery or trauma
Low uric acid (Hypouricemia) may indicate, cause or be caused by:
- 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)
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.
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.
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
- Malabsorption in the intestines
The doctor may then order a prealbumin test and other tests to determine the nature of the problem.
Reference range: 0 to 25.0 mg/L (Australia and USA)
Albumin/Creatinine Ratio – Urine
Reference range: 0 to 3.5 mg/mmol
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.
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 Globulin levels are low, and indicates poor health.
Bilirubin is the yellow-coloured pigment in the bile, produced as the liver breaks down heme (iron) 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 fats),
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.
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
- Congestive heart failure
- Malignancy involving liver
- Giant Cell Arteritis, especially with Cholestasis
- Bone / Skeletal issues involving osteoblast hyperactivity and bone remodeling:
- Paget’s disease
- Shingles (Herpes Zoster virus)
- Osteogenic sarcoma
- Osteoporosis treatment
- Adrenal cortical hyperfunction
- From other conditions:
- Pregnancy (late, as the placenta produces ALP)
- MEN II (Multiple endocrine neoplasia)
- Granulation tissue
- Gastrointestinal inflammation (Inflammatory Bowel Disease, Ulcerative colitis, Crohn’s, ulcers)
- Systemic infections (sepsis)
- 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
- 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
- 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)
- Excessive alcohol consumption
- Panadol, Parecetamol, Acetaminophen, Tylenol
- Rapidly growing children
- Liver cancer
- Heart attack
- Thyroid disease
- 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
- 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
- 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 article.
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 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, and over 3% of those over 50 are SEVERELY deficient, so supplementation is recommended for seniors.
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 with side-effects several pages long, and 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. Preferred supplement is https://au.iherb.com/pr/Lake-Avenue-Nutrition-Methyl-Folate-800-mcg-120-Veggie-Capsules/96310
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 is a manufactured synthetic product, commonly used in vitamin supplements and some foods.
Folic Acid is not a complete substitute for natural folate.
Note: Many people have one or two mutations at the MTHFR C677t Gene that prevents the partial or full conversion from folate to the active form, MTHF ((6S)-5-MethylTetraHydroFolate) or Methyl Folate. Always ask for Methyl Folate or Active Folate, and NEVER use Folic Acid, which can block absorption of the real thing. For those with the MTHFR issue, taking Folic Acid will often make the problem worse.
This gene can be inherited or due to lifestyle, and up to 40% of the population have varying forms, producing very mild (one mutation) to very severe (two mutations) symptoms.
We can ask for a MTHFR (also known as MethylTetraHydroFolate Reductase) test, or simply use the Methyl Folate.
Low folate produces symptoms such as high homocysteine, hypothyroidism, lethargy, impaired cognitive function, and mood disorders.
NOTE: Out of range B-12 can mask testing results of Folate and vice versa, so BOTH should be tested at the same time.
Homocysteine (Hcy) is an amino acid.
Reference range: 5 to 15 𝝻mol/L, some labs say 4 to 17 𝝻mol/L.
Normally higher in men than women.
Optimal range is below 7 𝝻mol/L.
Elevated levels (Hyperhomocysteinaemia or HHcy): Mild (15-30 𝝻mol/L), Moderate (30-100 𝝻mol/L) or Severe (>100 𝝻mol/L).
High Homocysteine can be caused by low folate, low B12, low B6, too much alcohol, hypothyroidism, kidney disease, Alzheimer’s disease, poor diet, toxins, hormone imbalances, stress, cancer or HCU (Homocystinuria, an inherited disorder).
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: www.leanmachine.net.au/healthblog/why-we-need-b-12-b-6-active-folate-and-tmg.
Those with one or two mutations at the MTHFR C677t gene may have problems controlling Homocysteine.
Serum iron test alone is not sufficient. There are three different iron tests below, which should be used inconjunction with the Ferritin test.
Serum Iron: Men: 12.5 to 31.3 nmol/L, Women: 8.9 to 26.8 𝝻mol/L
TIBC (Total Iron Binding Capacity) Men and Women: 45 to 76 mcmol/L.
Transferrin Saturation: Men 10% to 50%, Women 15% to 50%. Used to determine how well iron is metabolised in the body.
Out of range values can be diet, anaemia, bleeding, lead poisoning, liver, kidney, rheumatoid arthritis, hemochromotosis, supplement overdose.
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 “Goldilocks” levels. Not too low, not too high. Optimum is 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, and should be 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
- Iron-rich diet
- Taking unwarranted iron supplements
- Receiving blood transfusions
Low ferritin can be caused by:
- Bleeding (externally or internally)
- Heavy menstrual periods
- 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 (Inositol Hexaphosphate) 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®) can chelate iron, also aluminium
- 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. Not 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
NEVER 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.
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.
Vitamin E (at high doses of 600 to 1200 mg daily) or Vitamin C (1 gram or more daily) taken for 3 months can affect HbA1c results.
Chronic alcohol and opioid consumption can also cause false results.
Typical test is a “lipid study” which includes total cholesterol, LDL, HDL and triglycerides.
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. Many 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 100mg 360 softgels 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 and 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.
The amount of fats (lipids) circulating in the bloodstream.
Healthy adults should have triglycerides less than 1.5 mmol/L.
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 heart attacks or other cardiovascular disease.
High CRP can be caused by so many things that alone it cannot diagnose any particular disease, but does indicate that further studies are required, and the test should be repeated after 2 weeks to ascertain if the treatment is working, or if the inflammation is getting worse.
A short story: Mrs LeanMachine was in good health, but one day had severe pains in the chest and neck, so bad that she thought she was having a heart attack. Off to the Hospital, about 2 minutes from our home. The doctor on duty was Mrs LeanMachine’s regular doctor and had a good history of her health (previously damaged by years on statins and Nexium) and ran some blood tests, which proved that she had not had a heart attack, but her CRP was 49. Surely this indicated severe inflammation, but she was sent home and told to take pain killers. No follow-up, no further tests, that was it. Later, the pain had subsided, but at my request, a different doctor ordered an ultrasound, and sure enough, the gall bladder was full of stones, including two large stones looking like a pair of black dice (hard black cubes) and about the same size. For gall bladder problems, there are natural treatments, but when the gall bladder is badly inflamed and stones are too large to pass into the bile duct, removal is possibly the best option, especially when the removal can be performed as “keyhole” which is much less invasive than the major surgery required in an emergency if the problem gets worse.
So the gall bladder was removed via keyhole, and recovery was only a few days, and almost full. Careful attention to diet is required after gall bladder removal.
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
Australian Doctors have long insisted that Lyme Disease does 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 (bad diet, over 60 years of age, overweight, family history of prostate cancer) should be tested on a regular basis if the first test is high. Otherwise healthy men should have the PSA test included with an annual blood work to look for changes.
Although a low PSA result is preferred, we aim to look for any change in the result between tests, say at least 3 months apart. A significant increase in the value is more important than the actual number, as some men have a higher reading which is normal for them, others have a low reading which is normal for them. It is a sudden upward shift that is cause for further investigation.
This PSA test has nothing to do with Benign Prostate Enlargement which is not cancerous, but often affects quality of life by urgent and frequent urination. A high PSA result may be due to Benign Prostate Enlargement or some other condition.
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.
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.
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)
- 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.
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
– 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.
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.
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
- Celiac disease
- Crohn’s disease
- Immune thrombocytopenia
- Selective immunoglobulin M deficiency, a rare and sometimes hereditary disorder
- Wiskott-Aldrich syndrome, a rare immune deficiency disorder
- Lymphoid nodular hyperplasia
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).
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
- 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.
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
- 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.
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:
- Cows Milk
- Wheat (gluten)
When allergic reactions occur, levels of IgE are tested, and in some cases IgA
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.
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),
citrus bioflavonoids (diosmin, hesperidin,
rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin,
fermented foods (sauerkraut, kimchi, fermented soy, fermented raw dairy, apple cider vinegar, kombucha).
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
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.
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.
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 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)
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.
|Weeks of pregnancy is defined as completed weeks beginning with the start of the last menstruation phase.|
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
- 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
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|
Respiration Rate (RR)
|Bradypnea||< 12 breaths per minute|
|Normal (eupnea)||12 – 18|
|Fever||> 37.5 ° C|
|Normal||36.5 – 37.5 ° C (approximate)|
|Hypothermia||< 35.0 ° C|
Five Blood Tests for Everyone Over 50
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.
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.
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.
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.
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
- Atresia of the oesophagus
- Multiple pregnancy
Down Syndrome markers:
Amniotic Fluid AFP (alpha-fetoprotein)
Maternal AFP (Alpha-Fetoprotein Test) 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.
FNT (Fetal Nuchal Translucency) 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 (where the fetus has 47 chromosomes instead of 46), 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 women have different markers than lighter women, and those who smoke 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.
AFP can be present at very low levels in non-pregnant people, and the test may indicate other problems.
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 and 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.
AFP 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
See also AFP test above.
pregnancy-associated plasma protein A (PAPP-A)
To be advised…
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 acquire 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
- 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.
Organic Acids Test
This test is from a catch-mid-stream urine sample of minimum 5 mL.
The test looks at complex biomarkers from various metabolic pathways to give an overview of several major systems in the body and gives an analysis of nutritional deficiencies. Many functional medicine practitioners believe the organic acids test to provide the most useful data for dollar spent of any metabolic test.
In Australia, Medicare does not pay for this test, and only a few labs in the country offer it.
Performed on children suspected of having an inherited disorders resulting from a deficient enzyme or transport protein. The range of different pathways involved is very large and no one test can identify them all. Organic acids are excreted in the urine and allow us to see problems in several pathways including those involving amino acids, fatty acids and neurotransmitters. Symptoms range from relatively benign to severe presentations in the newborn period which may be fatal.
Possible clinical presentations include intellectual disability, seizures, tachypnoea (fast, shallow breathing), poor feeding, failure to thrive, vomiting, acidosis, coma.
Depending on the disorder, symptoms may be minimised or prevented by early diagnosis and treatment. Treatment may be based on dietary restrictions and/or supplementation with cofactors such as riboflavin (vitamin B2) or cobalamin (vitamin B12) or conjugating agents such as carnitine or sodium benzoate.
A normal organic acid test does not rule out other inherited errors of metabolism.
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. The doctor and lab should be aware of all prescription and over-the-counter medications, vitamins, etc as some can skew the results.
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! Remember that the results belong to you, no-one can refuse your request.
Refer to this site to check if the doctor is really telling the truth, bluffing, cannot be bothered, or has no idea.
Copyright © 1999-2020 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 ONLY after permission granted, email for link requests.
Written by Brenton Wight, Health Researcher, LeanMachine
Copyright © 1999-2020 Brenton Wight. All Rights Reserved.
This is a free, not-for-profit site, existing only to help everyone improve or regain health.
Updated 18th November 2020
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In 2010 at age 63, LeanMachine was not lean, he was obese. Over 100kg (about 220 pounds), sick almost all of the time, hair almost completely grey, allergic to nearly everything, continuous back pain, and no energy.
One year later at age 64, LeanMachine was 25kg lighter and lean at 74kg (about 162 pounds), never sick, no colds or flu, not even a headache, hair restored to 90% colour, allergies disappeared, no more back pain, full of energy, and stronger than he was 40 years earlier at the age of 24. How can this be? Just a few simple changes:
- Quit sugar
- Quit processed foods
- Quit all fizzy drinks
- Quit fried food
- Increase exercise
- Increase healthy fats
- Increase raw foods (salads)
- Decrease simple carbohydrates
- Eliminate bread, flour, cakes, pastries, etc
- Increase organic food intake
- Increase supplements: Vitamins, Minerals
- Increase Superfoods: wheatgrass and more
Now in 2020 at age 73, LeanMachine has not been sick in 10 years. No colds, no flu, no nausea, no pain, not even a headache in 10 years.
Supplements have helped along the way.
Note: The shop is now closed and is no longer available as I do not have enough hours in the day to keep up my research and process orders as well.
In the USA, the CDC (Centres for Disease Control) and the FDA (Food and Drug Administration) are run by people who have financial ties to the drug industry, and are actively trying to squash anyone, including LeanMachine, to promote low-cost or free healthy alternatives to expensive prescription drugs, vaccinations and medical procedures that may do more harm than good.
Various articles on my Facebook page have disappeared because Facebook, relying heavily on advertising from the big drug companies, have decided that anything to do with natural therapies or exposing truth about vaccines should be shut down. The big drug companies employ hundreds of people to post negative information on all media to discredit people like me, and hide the fact that hundreds of thousands of people every year that are killed by correctly prescribed and correctly taken prescription medication. LeanMachine still has a Facebook page, but there have been few posts for a long time, and never will be unless Facebook, Google, Amazon, Microsoft and others start upholding the truth instead of pushing Big Pharma propaganda.
This blog now contains many health articles from LeanMachine and many others renowned in the field of alternative medicine.
LeanMachine may not necessarily agree with all statements by others, but these articles are copyrighted by the original author, and are reproduced legally with no alterations.
Use the Search box to find articles relating to your topic.
Or use the category selection
Note that “alternative medicine” should be called Real Medicine, which has a successful history of thousands of years, while “conventional medicine” which uses drugs to treat symptoms rather than prevent the cause, is sending Governments broke while lining the profits of the drug companies, whose intent is to make more people sick so they can sell more drugs.
The USA is a prime example: In spite of the most expensive health care system on the planet, the population has the poorest health!
Epidemics of Cancer, Diabetes, Cardiovascular Disease, Alzheimer’s Disease, Obesity, Autism and other diseases are increasing as the population uses more non-organic foods, fried foods, bad oils (margarine, canola oil, etc), vaccinations containing mercury, aluminium and other toxins that hurt the heart and brain.
In another one or two generations, we will see the terrible effects of conventional medicine that cause catastrophic damage to the human race.
Alternative medicine is a way of avoiding all of these things.
LeanMachine cannot be responsible for the interpretation of any articles, regardless of the author, and everyone should seek qualified medical opinion before acting on any advice in any article here, especially if also taking prescription medication, which often uses the same biological pathway as some supplements, resulting in either a dangerous overdose or ineffective under-dose of prescription medication. Always inform your doctor if taking any supplement or specialised diet or any over-the-counter product.
LeanMachine has been studying nutrition and health since 2011 and has completed many relevant studies including:
- Open2Study, Australia – Food, Nutrition and Your Health
- RMIT University, Australia – Foundations of Psychology
- Swinburne University of Technology, Australia – Chemistry – Building Blocks of the World
- University of Washington, USA – Energy, Diet and Weight
- Johns Hopkins Bloomberg School of Public Health, USA – Health Issues for Aging Populations
- Johns Hopkins Bloomberg School of Public Health, USA – International Nutrition
- Johns Hopkins Bloomberg School of Public Health, USA – Methods in Biostatistics I & II
- Johns Hopkins Bloomberg School of Public Health, USA – Principles of Human Nutrition
- TUFTS University, USA – Nutrition and Medicine
- TUFTS University, USA – Lipids/Cardiovascular Disease 1 & II
- Technical Learning College, USA – Western Herbology, Identification, Formulas
- Bath University, England – Inside Cancer
- WebMD Education – The Link Between Stroke and Atrial Fibrillation
- WebMD Education – High Potassium: Causes and Reasons to Treat
- Leiden University Medical Center, Netherlands – Anatomy of the Abdomen and Pelvis
- MIT (Massachusetts Institute of Technology) – A Clinical Approach to the Human Brain
- LeanMachine has now examined thousands of studies, journals and reports related to health and nutrition and this research is ongoing
Copyright © 1999-2020 Brenton Wight and BJ & HJ Wight trading as Lean Machine abn 55293601285
Some products I use and recommend may or may not earn me a very small commission, but this is much less than the cost of operating this site, which is provided at my cost to help others with various health issues. Any information provided by myself or other authors on this site should be used in conjunction with that provided by your professional health provider.