10 Important Blood Tests PART-1 PDF

10 Essential Blood Tests – Part 1
Dr. Dicken Weatherby
Presents
10 Essential Blood
Tests
PART 1
The Blood Chemistry Webinars With
DR. DICKEN WEATHERBY
Creator of the Blood Chemistry Software
Essential Blood Test #1:
Basic Chem Screen
and CBC
© Weatherby & Associates, LLC
http://BloodChemSoftware.com 1
Functional Hierarchy
Top Metabolic Patterns
• Globulin and Total Protein
• Liver Enzymes
• GGTP, Bilirubin & Alk Phos
• Albumin
• Uric Acid
• Alk phos
• Ferritin and MCV
• LDH
• Potassium
• BUN and Creatinine
Globulin and Total
Protein
Hypochlorhydria and
Gastric Inflammation
Digestive Dysfunction and Protein
Deficits Reference Ranges
Optimal Range
Total Protein 6.9 – 7.4
Globulin 2.4 – 2.8
Elevated Globulin:
Hypochlorhydria Pattern
• An increased total globulin (>2.8)
• Normal or decreased total protein (<6.9) and/or
albumin (<4.0)
• Increased BUN (>16)
• Decreased serum phosphorous (<3.0)
• Other values
– An increased MCV (>90) and MCH (>31.9),
– Decreased or normal calcium (<9.2) and Iron (<50)
– Decreased CO2 (<25)
– Increased Anion Gap (>12)
– Decreased alkaline phosphatase (<70)
Low Protein‐ GI dysfunction &
inflammation Pattern
• Decreased protein (<6.9),
• Decreased total globulin (<2.4),
• Decreased serum phosphorus (<3.00),
• Increased BUN (>16),
• Decreased Creatinine (<0.9)
Chronic versus Acute
SGOT/AST, SGPT/ALT &
GGTP
Getting the Most from the
Liver Panel
Liver Panel‐ Reference
Ranges
Test Optimal Value
SGOT/AST 10 – 26
SGPT/ALT 10 – 26
GGTP 10 – 30
GGTP, ALK PHOS, &
BILIRUBIN
Getting to the Bottom of
Your Patients’ Gallbladder
Problems
Hepato‐Biliary Function‐
Optimal Ranges
Optimal Range
GGTP 10 – 30
Alk Phos 70 – 100
Bilirubin- total 0.1 – 0.9 or 1.7 – 15.4
umol/L
Bilirubin- direct 0 – 0.19 or 0.0 – 3.25
umol/L
Total Cholesterol 160-180 or 3.9-5.7 mmol/L
Biliary Dysfunction:
Biliary Stasis & Insufficiency
• Suspect biliary insufficiency or biliary stasis
if the GGTP is increased (>30).
• Bilirubin levels may also be elevated (>0.9
or 15.4 mmol/L) along with alkaline
phosphatase (>100) and total cholesterol
(>220 or 5.69 mmol/L). SGOT/AST and
SGPT/ALT may be normal or increased (>30).
• Many cases of biliary insufficiency or stasis
will show normal lab values.
Intrahepatic Biliary Obstruction

‐ Pattern
• Elevated total bilirubin (>1.2 or >20.5
mmol/L)
• Elevated Indirect bilirubin (>0.7 or 12
umol/L)
• Increased GGTP (>30),
• Increased SGPT/ALT (>30),
• Increased alk phos (>100) and/or
• Increased LDH (>200).
Extrahepatic Biliary Obstruction ‐

Pattern
• GGTP (>85)
• Alk Phos (>140)
• Normal or increased SGOT/AST (>55)
• Normal or increased SGPT/ALT (>55)
• Elevated total bilirubin (>1.2 or >20.5
umol/L)
• Elevated Direct Bilirubin (>0.2 or 3.4 umol/L)
Albumin
Liver Dysfunction and
Oxidative Stress
Oxidative Stress‐
Reference Ranges
Optimal Range
Albumin 4.0 – 4.5 or 40 – 50
Cholesterol 160-180 or 3.9-5.7 mmol/L
Oxidative Stress Pattern
• Total cholesterol level suddenly below its
historical level and seen with:
• Decreased albumin (<4.0)
• Decreased platelet level (<150)
• Decreased lymphocyte count (<20)
• Increased total globulin (>2.8 or 28)
• Increased Uric acid level (>5.9 or >351 men
and >5.5 or 327 women)
• May also see increased Ferritin, bilirubin
and LDL levels
Uric Acid
Poor Detoxification
Poor Detoxification‐
Reference Ranges
Optimal Value
Uric acid Males: 3.5 – 5.9 or 208 – 351 mmol/L
Females: 3.0 – 5.5 or 178 – 327 mmol/L
Decreased uric acid level (♀ <3.0 or <178

mmol/L, ♂< 3.5 or < 208 mmol/L)
and a normal MCV (82 – 89.9) and MCH
(28 – 31.9)
Alk Phos
Zinc Deficiency
Zinc Deficiency‐
Reference Ranges
Optimal Value
Alk Phos 70 – 100
• Decreased Alk Phos (<70) associated

with zinc deficiency.
• WBC and/or RBC zinc levels may also
be decreased along with a low normal
or decreased total WBC (<5.0).
Nutrient Deficiencies
and Anemia
Anemia‐ Reference Ranges
Optimal
MCV 82.0 – 89.9
RBC Count Male: 4.2 – 4.9
Female: 3.9 – 4.5
HCT Male: 40 – 48 or 0.4 – 0.48
Female: 37 – 44 or 0.37 – 0.44
HGB Male: 14 – 15 or 140 - 150
Female:13.5 – 14.5 or 135 - 145
MCH 28 – 31.9
MCHC 32 – 35
RDW <13
Ferritin
Iron Deficiency Anemia
Iron Deficiency Anemia‐
Reference Ranges
Optimal Value
Total Iron 85 – 130 or

15.22 – 23.27 mmol/L
Ferritin 30 – 70
% Sat 25 – 30% or 0.25 – 0.30
TIBC 250 – 350 or 44.8 – 62.7
Iron Deficiency Anemia
Pattern
• Decreased HCT (♀ <37 or <0.37, ♂ <40 or 0.40)
• Decreased HGB (♀ <13.5 or <135, ♂ <14.0 or <140)
• Decreased MCV (<82), MCH (<28), and MCHC (32)
• Decreased serum iron (<85 or <15.22)
• Decreased ferritin (<10 – 15 in women, <20 in
men),
• Decreased % transferrin saturation (<16% or
<0.16)
• An increased RDW (>13)
MCV
B12/Folate‐ Deficiency
B12 Deficiency‐
Reference Ranges
Optimal Value
MCV 82.0 – 89.9
B12/Folate Deficiency
Anemia‐ Pattern
• Increased MCV > 89.9
• Increased MCH >31.9
• Increased RDW >13,
• Increased MCHC >35,
• Increased LDH >200
• Decreased uric acid level (♀ <3.0 or
<178, ♂<3.5 or <208)
• Hypersegmented neutrophils
Nutrient Deficiency
Anemia Summary
RBC HCT HGB MCV MCH/ Iron
MCHC
Iron      
def.
B12/      
folate
LDH
Reactive Hypoglycemia
Reactive Hypoglycemia‐
Reference Ranges
Optimal Range
LDH 140 - 200

Blood Glucose 75– 86 mg/dl or 4.16
– 4.77 mmol/L
Hypoglycemia‐ Reactive
• Liver and Adrenal connection
• Liver glycogen problem
• Pattern:
– Decreased blood glucose (<75 or
<4.16 mmol/L)
– Decreased LDH (<140)
• Clinical indicators
Potassium
Adrenal dysfunction
Adrenal Dysfunction‐
Reference Ranges
Optimal Range
Potassium 4.0 – 4.5

Sodium 135 – 142
Sodium:Potassium 30 - 35
Ratio
Adrenal Insufficiency‐
Pattern
• Adrenal insufficiency is possible if:
– Potassium levels are increased (>4.5)
– Sodium is normal or decreased (<135)
– Sodium:Potassium Ratio decreased (<30)
– Chloride values will often follow sodium
• Other values that may be out of balance
include:
– Increased triglyceride and cholesterol levels
– Decreased aldosterone and Cortisol levels
Adrenal Stress Pattern
• Adrenal stress is possible if:
– Potassium levels are decreased (<4.0)
– Sodium is normal or increased (>142)
– Sodium:Potassium Ratio increased (>35)
– Chloride values will often follow sodium
• Other values that may be out of balance
include:
– Decreased triglyceride and cholesterol levels
– Increased aldosterone and cortisol levels.
BUN and Creatinine
Renal Insufficiency
Renal Insufficiency
Reference Ranges
Optimal Range
BUN 10 - 16 or 3.57 – 5.71 mmol/L

Creatinine 0.8 – 1.1 or 70.7 – 97.2 mmol/L
Renal Insufficiency
• Background
• Contributing Factors
• Kidney/Liver Connection
Renal Insufficiency ‐ Pattern
• Increased BUN: >16 or > 5.71 mmol/L,
• Increased or Normal Creatinine: >1.1 or
> 97.2 mmol/L
• Increased or Normal Uric Acid: ♀ >5.5,
♂ >5.9 or ♀ >327, ♂ >351
• Increased Phosphorous: >4.0 or >1.29
• LDH and AST usually Normal
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What are the main components of a basic chem screen and CBC?

What are some of the key patterns that can be identified by analyzing globulin and total protein levels?

10 Essential Blood Tests – Part 1

Intrahepatic Biliary Obstruction

Extrahepatic Biliary Obstruction ‐

Uric acid Males: 3.5 – 5.9 or 208 – 351 mmol/L

Females: 3.0 – 5.5 or 178 – 327 mmol/L

Decreased uric acid level (♀ <3.0 or <178

• Decreased Alk Phos (<70) associated

Total Iron 85 – 130 or

MCV 82.0 – 89.9

LDH 140 - 200

Potassium 4.0 – 4.5

BUN 10 - 16 or 3.57 – 5.71 mmol/L

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