January 26, 2012

The answers are in your blood

Yes, you need to face the needle: Regular tests are best

By Amy Leap Pocono Record Writer

January 26, 2012

The body is an intricate machine, and normally all the organs and functions work together to keep you healthy. But doctors need to check now and then to ensure everything is working as it should — and an external exam won't suffice.

"Blood tests are one of the best ways for a physician to gain information about your health," said Anna Friemann of Hamilton Township. She is a nurse in the Level II Neuro Trauma Center at Community Medical Center, Scranton.

The Centers for Disease Control and Prevention advises having routine blood tests done somewhere around 35 and 40 years old. This gives the doctor a starting point to monitor any changes as you get older.

"At around the age of 50, there are specific blood tests the doctor should order on a yearly basis, and if you haven't had the tests, you should ask the physician about having them," she said.

When the doctor orders the lab to run a complete series of tests, you can find out about the status of the liver, the thyroid, the blood cholesterol as well as the blood sugar, Friemann said.

Women and men 50 and older

The following blood chemistry tests require a single sample of blood serum, which may require several vials of blood that can be used to run a series of tests quickly and inexpensively.

The following are the most commonly requested tests:

r Complete Blood Count is the most common test and is usually ordered as part of a complete physical examination. CBC measures the number, size and shape of the types of cells in the blood.

r Glucose test can indicate diabetes if the level is high, or hypoglycemia if it is low. A fasting glucose of less than 100 is normal, a level of 100 to 125 is abnormal and called "impaired glucose tolerance" and a level of 126 or greater means diabetes.

r Blood Urea Nitrogen and creatinine tests see if the kidneys are working normally and measures the amount of nitrogen in blood that comes from the waste product urea. Urea is made when protein is broken down in the body. Urea is made in the liver and passed out of the body in the urine. If the kidneys are not able to remove urea from the blood normally, the BUN level rises.

The level of creatinine in the blood also tells how well the kidneys are working. A high creatinine level may mean the kidneys are not working properly. BUN and creatinine tests can be used together to find the BUN-to-creatinine ratio that tells if the kidneys are working properly.

r Sodium, potassium and chloride tests are especially important when taking diuretics, known as water pills. The tests measure the blood salts or electrolytes.

r Uric Acid test measures the level of acid, a waste product of all cells. An elevated level could mean kidney disease or gout.

r Albumin test measures the blood protein the liver produces. A low albumin count can be a sign of liver or kidney disease.

r Globulin test measures the level of blood protein produced by the immune system. A high level can point to chronic inflammation, infection or blood disorders, such as multiple myeloma.

r Calcium test has nothing to do with how much calcium is in the bones. It is a component of the blood that helps all the cells in the body function normally. A high count can point to a disorder called hyperparathyroidism, which predisposes people to kidney stones and low bone density.

r Serum Glutamine Pyruvic Transaminase test measures an enzyme normally present in liver and heart cells. SGPT is released into the blood when the liver or heart is damaged. Elevated levels of SGPT can happen as a result of a heart attack or from viral hepatitis.

r Lactate Dehydrogenase test measures an enzyme produced by many cells of the body. If LDH is extremely high, it can indicate a malignancy, and the doctor will do additional tests to rule this out.

r Bilirubin test measures a chemical in bile that gives it the yellow color. If the bile passages from the liver to the intestine are blocked, the bilirubin level will be high. Possible causes include gallstones and liver disease.

r Gamma Glutamyl Transpeptidase test measures the amount of enzyme produced by the liver. Obesity and excessive alcohol use are the most common reasons it can be mildly increased. It will also be elevated when there is blockage of bile and with liver disease.

r Blood fats or blood lipids test identifies lipids, often listed together in a separate "panel" on the blood chemistry report as Low Density Lipoprotein and High Density Lipoprotein. The total cholesterol is the sum of the LDL and HDL. High total cholesterol levels are linked to heart disease. The lower the total cholesterol the better. A total below 200 is desirable.

HDL is the good cholesterol. The more of it, the better. Ideally, the HDL cholesterol should be at least 30 percent of the total amount. In men, an HDL greater than 40 is normal; in women, an HDL greater than 50 is normal.

LDL is the bad cholesterol. A high LDL puts the patient at risk for heart disease, and the doctor will suggest diet and often medication to get the LDL cholesterol below 130. If diabetes or heart disease is present, the treatment goal for LDL cholesterol should be below 100.

Triglycerides are the other form of fat in the blood. The level will be much higher after a meal. If the level is out of range, it should be repeated after an overnight fast. Elevated levels increase the risk of heart disease and could be a sign of early diabetes. Ideally, they should be under 150.

r Thyroid function test can diagnose an underactive thyroid, a common condition in women over age 50. It also measures the level of two hormones produced by the thyroid glands: thyroxine 3 (T3) and thyroxine 4 (T4). Both regulate the metabolism.

The brain keeps levels normal by sending thyroid stimulating hormone (TSH) to the thyroid gland if the T3 and T4 are low. The TSH level is the best indicator of the condition of the thyroid and the effects of thyroid medication.

For example, if the thyroid hormone levels (T3 and T4) are low, the TSH level will be high. If the thyroid hormone levels are too high, then the TSH level will be low or immeasurable.

Just for women

r C-reactive protein test measures blood inflammation and marker of future heart disease risk. The test is recommended for women with a waist circumference over 35 inches because of increased risk for metabolic syndrome and heart disease.

Just for men

r Prostate-Specific Antigen test measures the prostate-specific protein produced by cells of the prostate gland. A high PSA can mean prostate cancer or prostate inflammation.

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