Tweet
Dasoham
adiyen srinivasan pranams
This is an article forwarded to me by a friend. i thought that this may be useful to our members.
The article has been cropped to accommodate only 30000 words. full article contains about 42000 words.
I could not attach the same as file.
regards
Srinivasan
The Simplified Patient Reference Guide
By Ronald J. Grisanti D.C.
2
GLUCOSE
Glucose: This is the chief source of energy for all living organisms. A level
greater than 105 in someone who has fasted for 12 hours suggests a diabetic
tendency. If this level is elevated even in a non-fasting setting one must be
concerned that there is a risk for developing diabetes. This is an incredibly
powerful test and can predict diabetes ten years or more before one develops the
strict definition of diabetes which is levels greater than 120.
Common Causes of Glucose Increase: Diabetes, poor carbohydrate utilization,
syndrome X
Clinical Adult Range: 70-115 mg/dL
Optimal Adult Range: 85-100 mg/dL
Red Flag Range <50 or >250 mg/dL
Clinical Notes: Order Glycohemoglobin (HGB A1C) with serum glucose values
above 160 and to monitor diabetics under therapy
Nutrition Tip: Thiamine Deficiency has been linked to increase in glucose
levels
6
SODIUM
Sodium: This element plays an important role in salt and water balance in your
body. A low level in the blood can be caused by too much water intake, heart
failure, or kidney failure. A low level can also be caused by loss of sodium in
diarrhea, fluid or vomiting. A high level can be caused by too much intake of salt
or by not enough intake of water.
Clinical Adult Range: 135-145
Optimal Adult Range: 140-144
Red Flag Range <125 or >155 mmol/L
POTASSIUM
Potassium: This element is found primarily inside the cells of the body. Low
levels in the blood may indicate severe diarrhea, alcoholism, or excessive use of
water pills. Low potassium levels can cause muscle weakness and heart
problems.
Clinical Adult Range: 3.5-5.0
Optimal Adult Range: 4.0-4.6
Red Flag Range <3.0 or >6.0 mmol/L
7MAGNESIUM
Magnesium: This important element is found in the arteries, heart, bone,
muscles, nerves, teeth.
Clinical Adult Range: 1.7-2.4
Optimal Adult Range: 2.2-2.6
Red Flag Range <1.2 mg/dL
Clinical Note: Magnesium should be evaluated on all patients suffering with
heart disease.
Clinical Note: Patient suffering with fibromyalgia may have a low serum
magnesium accompanied with a low C02 and an increased anion gap
Nutrition Tip: Excessive use of antacids containing magnesium may increase
magnesium levels
Clinical Note: If your magnesium is less than 2.0, it is strongly recommended to
have an erythrocyte magnesium test or a magnesium loading test
CHLORIDE
Chloride: Is an electrolyte controlled by the kidneys and can sometimes be
affected by diet. An electrolyte is involved in maintaining acid-base balance and
helps to regulate blood volume and artery pressure. Elevated levels are related
to acidosis as well as too much water crossing the cell membrane.
Clinical Adult Range: 96-110 mmol/L
Optimal Adult Range: 100-106 mmol/L
Red Flag Range <90 or >115 mmol/L
8Clinical Note: Suspect hypochlorhydria if chloride is below 100, the total globulin
is less than 2.4 and serum phosphorus is less than 3.0
Clinical Note: Chloride is required for the production of HCL by the chief cells of
the stomach
BLOOD UREA NITROGEN
BUN (Blood Urea Nitrogen): BUN is a waste product derived from protein
breakdown in the liver. Increases can be caused by excessive protein intake,
kidney damage, certain drugs, low fluid intake, intestinal bleeding, exercise, heart
failure or decreased digestive enzyme production by the pancreas. Decreased
levels are most commonly due to inadequate protein intake, malabsorption, or
liver damage.
Clinical Adult Range: 10-26 mg/dL
Optimal Adult Range: 13-18 mg/dL
Red Flag Range <5 or >50 mg/dL
Clinical Note: Decreased BUN less than 8 with a decreased urinary specific
gravity may indicate posterior pituitary dysfunction
Clinical Note: Increased BUN above 25 usually indicates kidney disease.
However, if Creatinine is not above 1.1, then kidney disease may not be the
problem. Instead consider anterior pituitary dysfunction, dehydration or
hypochlorhydria.
Nutrition Tip: Increased BUN may indicate a Boron deficiency
9CREATININE
Creatinine: Creatinine is also a protein breakdown product. Its level is a
reflection of the bodies muscle mass. Low levels are commonly seen in
inadequate protein intake, liver disease, kidney damage or pregnancy. Elevated
levels are generally reflective of kidney damage and need to be monitored very
carefully.
Clinical Adult Range: 0.7-1.5 mg/dL
Optimal Adult Range: 0.7-1.0 mg/dL
Red Flag Range >1.6 mg/dL
Clinical Note: Suspect early nephritis ( kidney disease) if creatinine is between
2-4 mg/dL. Suspect severe nephritis is creatinine is between 4-35 mg/dL
Common Causes of Creatinine Decrease: Amyotonia congenita
BUN/CREATININE RATIO
BUN/Creatinine Ratio: increased values may indicate catabolic states,
dehydration, circulatory failure leading to fall in renal blood flow, congestive heart
failure, acute and chronic renal (kidney) failure, urinary tract obstruction, prostatic
enlargement, high protein diet. Decreased values may indicate overhydration,
low protein/high carbohydrate diet, pregnancy
Clinical Adult Range: 6-10
Optimal Adult Range: 10-16
Red Flag Range <5 or >30
10URIC ACID
Uric Acid: Uric acid is the end product purine metabolism. High levels are seen
in gout, infections, high protein diets, and kidney disease. Low levels generally
indicate protein and molybdenum (trace mineral) deficiency, liver damage or an
overly acid kidney.
Clinical Female Range: 2.4-6.0 mg/dL
Clinical Male Range: 3.4-7.0 mg/dL
Optimal Female Range: 3.0-5.5 mg/dL
Optimal Male Adult Range: 3.5-5.9 mg/dL
Red Flag Range <2 mg/dL or >9.0 mg/dL
PHOSPHORUS
Phosphorus: Phosphorus is closely associated with calcium in bone
development. Therefore most of the phosphate in the body is found in the bones.
But the phosphorus level in the blood is very important for muscle and nerve
function. Very low levels of phosphorus in the blood can be associated with
starvation or malnutrition and this can lead to muscle weakness. High levels in
the blood are usually associated with kidney disease. However the blood must be
drawn carefully as improper handling may falsely increase the reading.
Clinical Adult Range: 2.5-4.5
Optimal Adult Range: 3.2-3.9
Red Flag Range <2.0 mg/dL or >5.0 mg/dL
11Less Common Causes of Phosphorus Decrease: Diabetes, liver dysfunction,
protein malnutrition, neurofibromatosis, myxedema
Nutrition Tip: Phosphorus is frequently decreased with diets high in refined
sugars
Clinical Note: Suspect Vitamin D deficiency with low levels of calcium,
phosphorus and increased levels of alkaline phosphorus
Clinical Note: Phosphorus is a general indicator of digestive function. Consider
hypochlorhydria when phosphorus is below 3.0 and total serum globulin is
greater than 3.0 or less than 2.4
CALCIUM
Calcium: Calcium is the most abundant mineral in the body. It is involved in
bone metabolism, protein absorption, fat transfer, muscular contraction,
transmission of nerve impulses, blood clotting, and heart function. It is highly
sensitive to elements such as magnesium, iron, and phosphorous as well as
hormonal activity, vitamin D levels, CO2 levels and many drugs. Diet, or even the
presence of calcium in the diet has a lot to do with "calcium balance" - how much
calcium you take in and how much you lose from your body.
Clinical Adult Range: 8.5-10.8
Optimal Adult Range: 9.7-10.1
Red Flag Range <7.0 mg/dL or >12.0 mg/dL
Clinical Note: Serum protein influences calcium levels. Calcium goes up with
increased protein and goes down with decreased protein
Clinical Fact: Poor intestinal fat absorption may be suspected with low levels of
calcium, bilirubin and phosphorus
Nutrition Note: Pancreatic enzyme deficiency may be suspected with low levels
of calcium, triglycerides and increased levels of LDH
12Clinical Note: Circadin rhythm abnormality should be a primary consideration
with calcium levels either above or below normal
ALBUMIN
Albumin: The most abundant protein in the blood, it is made in the liver and is
an antioxidant that protects your tissues from free radicals. It binds waste
products, toxins and dangerous drugs that might damage the body. Is also is a
major buffer in the body and plays a role in controlling the precise amount of
water in our tissues. It serves to transport vitamins, minerals and hormones.
Lower levels are seen in poor diets, diarrhea, fever, infections, liver disease,
kidney disease, third-degree burns, edemas or hypocalcemia.
Clinical Adult Range: 3.0-5.5
Optimal Adult Range: 4.0-4.4
Red Flag Range <4.0 g/dL
Clinical Note: Albumin 3.5 or below with a 1500 or less lymphocyte count is one
of the four OMINOUS signs
Nutrition Tip: Decreased albumin with decreased serum phosphorus may
indicate digestive inflammation
Calcium/Albumin Ratio: elevated in malnutrition or visceral protein loss.
Levels higher than 2.7 is one of the four OMINOUS signs
GLOBULIN
Globulin: Globulins have many diverse functions such as, the carrier of some
hormones, lipids, metals, and antibodies. High levels are found in chronic
infections, liver disease, rheumatoid arthritis, myelomas and lupus. Lower levels
may be seen in immune compromised patients, poor dietary habits,
malabsorption, liver and kidney disease.
Clinical Adult Range: 2.0-4.0
Optimal Adult Range: 2.8-3.5
Red Flag Range <2.0 g/dL or >3.5 g/100ml
A/G RATIO
A/G Ratio: is an important indicator of disease states. Low ratio suggests
ulcerative colitis, burns, kidney disease, cirrhosis, multiple myeloma.
A/G ratio less than 1.0 is one of the four OMINOUS signs
Clinical Adult Range: 1.1-2.5
Optimal Adult Range:1.2-1.5
Red Flag Range <1.0
Nutrition Note: Elevated A/G ratio, elevated protein and an elevated cholesterol
may indicate too high protein consumption
ALKALINE PHOSPHATASE
Alkaline Phosphatase: Alkaline phosphatase is an enzyme that is found in all
body tissue, but the most important sites are bone, liver, bile ducts and the gut. A
high level of alkaline phosphatase in your blood may indicate bone, liver or bile
duct disease. Certain drugs may also cause high levels. Growing children,
because of bone growth, normally have a higher level than adults do. Low levels
indicate low functioning adrenal glands, protein deficiency, malnutrition or more
commonly, a deficiency in zinc.
Clinical Adult Range: 30-115
Optimal Adult Range: 60-80
Red Flag Range <30U/L or >Laboratory range
Clinical Note: Any patient having a significant increase in Alkaline Phosphatase
should have a ALP isoenzyme
Clinical Note: It is considered ““NORMAL”” for Alkaline Phosphatase to be
elevated in children under 18 and people with bone fractures.
SGPT/ALT & SGOT/AST
Transaminases (SGTP/ALT) & (SGOT/AST): These are enzymes that are
primarily found in the liver. Drinking too much alcohol, certain drugs, liver disease
and bile duct disease can cause high levels in the blood. Hepatitis is another
problem that can raise these levels. Low levels of GGT may indicate a
magnesium deficiency. Low levels of SGPT and SGOT may indicate deficiency
of vitamin B6.
Clinical Adult Range: 0-41
Optimal Adult Range: 18-26
Red Flag Range >100 U/L
SGOT/AST is found in the heart, skeletal muscles, brain, liver and kidneys
Clinical Note: In acute congestive heart failure and/or myocardial infarction, the
SGOT/AST will significant increase. However, these values will slowly return to
normal. SGPT/ALT will also increase in these cardiac heart emergencies,
however, SGOT/AST normally will not return to normal as quick as SGPT
SGPT/ALT is found in the liver, kidneys, heart and skeletal muscles.
Common Causes of SGPT/ALT Increase: Acute hepatitis, cirrhosis of liver,
mononucleosis
Less Common Causes of SGPT/ALT Increase: Pancreatitis, biliary
dysfunction, diabetes
15Clinical Note: SGPT values are greater than SGOT in liver obstruction, toxic
hepatitis. SGOT values are greater than SGPT in cirrhosis of the liver, liver
neoplasms and jaundice
GGT
Gamma-Glutamyl transerase (GGT): Believed to be involved in the transport of
amino acids into cells as well as glutathione metabolism. Found in the liver and
will rise with alcohol use, liver disease, or excess magnesium.
Clinical Adult Range: 0-55U/L
Optimal Adult Range: 10-30U/L
Red Flag Range >90U/L
Common Causes of GGT Increase: Biliary obstruction, alcoholism,
cholangitis/cholecystitis (bile duct and gall bladder inflammation)
Clinical Note: If GGT is greater than 150 U/L with a serum bilirubin of over 2.8
mg/dL, strongly suspect biliary obstruction. Seek immediate medical attention
Clinical Note: If GGT values are five times higher than the clinical range suspect
pancreatitis
Less Common Causes of GGT Increase: Brucellosis, hepatitis, mononucleosis,
bacterial and viral infection, malignancy, congestive heart failure biliary.
Nutrition Note: Low levels of GGT may indicate a B-6 deficiency.
Additional Clinical Notes: Food allergy/sensitivity is a very common finding with
biliary dysfunction
LDH
Lactate Dehydrogenase (LDH): LDH is an enzyme found in all tissues in the
body. A high level in the blood can result from a number of different diseases
such as hepatitis, anemia etc. Also, slightly elevated levels in the blood are
common and usually do not indicate disease. The most common sources of LDH
are the heart, liver, muscles, and red blood cells.
Clinical Adult Range: 60-225U/L
Optimal Adult Range: 140-200U/L
Red Flag Range >250U/L
Common Causes of LDH Increase: Liver/biliary dysfunction, pulmonary
embolism, myocardial infarction, tissue inflammation, tissue destruction,
malignancy anywhere in the body, several types of anemias
Clinical Note: LDH will frequently increase with low thyroid function
Clinical Note: LDH is frequently increased with birth control usage
16Nutrition Note: Decrease LDH may indicate reactive hypoglycemia. (Check
glucose)
TOTAL PROTEIN
Total Protein: This is a measure of the total amount of protein in your blood.
Total protein is the combination of albumin and total globulin and is affected by
the albumin and total globulin. A low or high total protein does not indicate a
specific disease, but it does indicate that some additional tests may be required
to determine if there is a problem.
Clinical Adult Range: 6.0-8.5g/dL
Optimal Adult Range: 7.1-7.6g/dL
Red Flag Range <5.9g/dL or > 8.5g/dL
IRON
Iron: The body must have iron to make hemoglobin and to help transfer oxygen
to the muscle. If the body is low in iron, all body cells, particularly muscles in
adults and brain cells in children, do not function up to par. If this test is low you
should consider getting a Ferritin test, especially if you are a female who still has
menstrual cycles.
Clinical Adult Range: 40-150ug/ml
Optimal Adult Range: 50-100ug/ml
Red Flag Range <25ug/ml or >200ug/ml
Nutrition Note: Increased iron with decreased hemocrit (HCT) suggests intrinsic
factor deficiency
Clinical Notes: An iron evaluation is not complete without ordering Ferritin (see
below)
FERRITIN
Ferritin: This test is considered the "gold standard" in documenting iron
deficiency anemia. Low levels below 25 indicate a need for iron. High levels may
an inflammatory disorder, infections, rheumatoid arthritis, chronic kidney disease
Clinical Male Adult Range: 33-236ng/mL
Clinical Female Adult Range (before menopause): 11-122ng/mL
Clinical Female Adult Range (after menopause): 12-263ng/mL
Optimal Male Adult Range: 20-200ng/mL
Optimal Female Adult Range (before menopause): 10-110ng/mL
Optimal Female Adult Range(after menopause): 20-200ng/mL
Red Flag Range <8ng/mL or >500ng/mL
Clinical Notes: Serum ferritin greater than 1000 suspect hemochromatosis
Clinical Notes: Iron overload and/or hemochromatosis are silent and can result
in cirrhosis of the liver, bacterial infections, dementia, arteriosclerosis, diabetes
and stroke
Nutrition Note: Doctors specializing in chelation have found a correlation with
increased iron and arteriosclerosis.
TRIGLYCERIDES
Triglycerides: These are fats used as fuel by the body, and as an energy source
for metabolism. Increased levels are almost always a sign of too much
carbohydrate intake and hyperlipidism. Decreased levels are seen in
hyperthyroidism, malnutrition and malabsorption.
18Clinical Adult Range: 50-150mg/dL
Optimal Adult Range: 70-110mg/dL
Red Flag Range <35mg/dL or >350mg/dL
Clinical Notes: Resistive exercise training has been found to be effective in
lowering elevated triglycerides
CHOLESTEROL
Cholesterol: Group of fats vital to cell membranes, nerve fibers and bile salts,
and a necessary precursor for the sex hormones. High levels indicate diet high in
carbohydrates/sugars. Low levels indicate low fat diet, malabsorption, anemia,
liver disorders, carbohydrate sensitivity. Cholesterol values below 140 are
considered one of the four OMINOUS signs.
Clinical Adult Range: 120-200mg/dL
Optimal Adult Range: 150-180mg/dL
Red Flag Range <50mg/dL or >400mg/dL
Nutrition Note: Increased cholesterol levels have been found to be lowered by
the amino acid methionine
Clinical Notes: Cholesterol level below 130 is considered an Ominous sign
Clinical Notes: If cholesterol is above 220 with a SGPT below 10 suspect liver
congestion/fatty liver
LDL CHOLESTEROL
LDL Cholesterol: LDL is the cholesterol rich remnants of the lipid transport
vehicle VLDL (very-low density lipoproteins) there have been many studies to
correlate the association between high levels of LDL and arterial arteriosclerosis.
19Clinical Adult Range: <130mg/dL
Optimal Adult Range: <120mg/dL
Red Flag Range >180mg/dL
Nutrition Note: Increased cholesterol levels have been found to be lowered by
the amino acid methionine
HDL
HDL (High Density Lipoprotein): HDL or High-density lipoprotein is the
cholesterol carried by the alpha lipoproteins. A high level of HDL is an indication
of a healthy metabolic system if there is no sign of liver disease or intoxication.
the two mechanisms that explain how HDL offers protection against chronic heart
disease are that HDL inhibits cellular uptake of LDL and serves as a carrier that
removes cholesterol from the peripheral tissues and transports it back to the liver
for catabolism.
Clinical Adult Males Range: >50mg/dL
Clinical Adult Female Range: >55mg/dL
Optimal Adult Male Range: >55mg/dL
Optimal Adult Male Range: >60mg/dL
Red Flag Range <35mg/dL
Nutrition Note: Diets high in refined carbohydrates, lack of exercise and genetic
predisposition have been found to lower HDL
Clinical Notes: If HDL is decreased, triglycerides are greater than 50% of the
cholesterol value, LDL is increased and uric acid is increased rule out
arteriosclerosis
CHOLESTEROL/HDL RATIO
Cholesterol/HDL ratio: this ratio is an important marker for cardiovascular
health. A ratio <4.0 is considered adequate. A ratio <3.1 is ideal.
CO2
CO2: The CO2 level is related to the respiratory exchange of carbon dioxide in
the lungs and is part of the bodies buffering system. Generally, when used with
the other electrolytes, carbon dioxide levels indicate pH or acid/alkaline balance
20in the tissues. This is one of the most important tests that we measure. Most
people have too much acid in their body. If you garden you will know that it is
very difficult to grow plants in soil where the pH is incorrect. Our blood is similar
to soil in many respects and it will be difficult to be healthy if our body's pH is not
well balanced.
Clinical Adult Range: 24-32mmol/L
Optimal Adult Range: 26-30mmol/L
Red Flag Range <18mmol/L or >38mmol/L
Nutrition Note: Low levels of CO2 may indicate a need for thiamine (a B-
vitamin)
Clinical Notes: If CO2 is above 32mmol/L, a Pulmonary Function Test should is
warranted
WHITE BLOOD CELLS
White Blood Cell (WBC): White blood count measures the total number of white
blood cells in a given volume of blood. Since WBCs kill bacteria, this count is a
measure of the body's response to infection.
Clinical Adult Range: 4,500-11,000cu.mm
Optimal Adult Range: 5,000-8,000cu.mm
Red Flag Range <3,000cu.mm or >13,000cu.mm
Nutrition Note: Decreased WBC may indicate a need for Vitamin B-12, B-6 and
folic acid.
21Clinical Notes: An increase or decrease in total WBC in conjunction with a
lymphocyte count below 20 and serum albumin below 4.0 is a pattern frequently
seen in a developing neoplasm (tumor)
NEUTROPHILS
Neutrophils: elevated in acute infection
Clinical Adult Range: 35-65 percent of total WBC
Optimal Adult Range: 40-60 percent of total WBC
Red Flag Range <30 percent of total WBC or >80 percent of total WBC
MONOCYTES
Monocytes: elevated in bacterial infections, protozoal infections
Clinical Adult Range: 0-10 percent of total WBC
Optimal Adult Range: <7 percent of total WBC
Red Flag Range >15 percent of total WBC
Clinical Notes: Increased monocytes are frequently present with prostate
hypertrophy, ovarian and uterine dysfunction
Clinical Notes: An increase in monocytes with an increase in the basophils
(>1.0) and a mild increase of eosinophils (>3.0) may indicate intestinal parasites
LYMPHOCYTES
Lymphocytes: elevated in acute and chronic infections. Decreased in viral
infection and immune deficiency
Clinical Adult Range: 20-40 percent of total WBC
Optimal Adult Range: 25-40 percent of total WBC
Red Flag Range <20 percent of total WBC or >55 percent of total WBC
Clinical Notes: Suspect a viral infections when the lymphocytes increase to a
point that either equal or exceeds the neutrophil level
EOSINOPHILS
Eosinophils: Elevated in allergic conditions, skin diseases, parasitic diseases
Clinical Adult Range: 0-7 percent of total WBC
Optimal Adult Range: 0-3 percent of total WBC
Red Flag Range <20 percent of total WBC or >55 percent of total WBC
Common Causes of Eosinophils Increase: Allergic condition (asthma), food
sensitivities, parasitic infection
Less Common Causes of Eosinophils Increase: Chemical/heavy metal
toxicity, Hodgkin’’s dis ease, ovarian and bone tumors
BASOPHILS
Basophils: Elevated in Infections
Clinical Adult Range: 0-2 percent of total WBC
Optimal Adult Range: 0-1 percent of total WBC
Red Flag Range <5 percent of total WBC
Clinical Notes: Consider ordering a comprehensive stool and digestive test to
rule out intestinal parasites if the basophils are increased with no sign of
inflammation
23RED BLOOD CELLS
RBC (Red Blood Cells): made in the spleen. Reveals the oxygen carrying ability
of the blood.
Clinical Adult Male Range: 4.60-6.0 million cu/mm
Clinical Adult Female Range: 3.90-5.50 million cu/mm
Optimal Adult Male Range: 4.20-4.90 million cu/mm
Optimal Adult Female Range: 3.90-4.50 million cu/mm
Red Flag Range for Men <3.90 or >6.00 million cu/mm
Red Flag Range for Women <3.50 or >5.00 million cu/mm
Nutrition Tip: Low levels of RBC may indicate a need for B-12, B-6 and folic
acid
Clinical Notes: Consider checking iron and ferritin levels with low levels of RBC
HEMOGLOBIN
Hemoglobin: Hemoglobin provides the main transport of oxygen and carbon in
the blood. It is composed of "globin", a group of amino acids that form a protein
and "heme", which contains iron. It is an important determinant of anemia
(decreased hemoglobin) or poor diet/nutrition or malabsorption.
Clinical Adult Male Range: 13.5-18.0g/dL
Clinical Adult Female Range: 12.5-16.0g/dL
Optimal Adult Male Range: 14.0-15.0g/dL
Optimal Adult Female Range: 13.5-14.5g/dL
Red Flag Range <10.0 or >17g/dL
Nutrition Tip: Low levels of Hemoglobin may indicate a need for B-12, folic acid
and thiamine Clinical Notes: Consider checking iron and ferritin levels with low levels of
Hemoglobin
HEMATOCRIT
Hematocrit: Hematocrit is the measurement of the percentage of red blood cells
in whole blood. It is an important determinant of anemia (decreased), dehydration
(elevated) or possible overhydration (decreased).
Clinical Adult Male Range: 40.0-52.0 percent
Clinical Adult Female Range: 36.0-47.0 percent
Optimal Adult Male Range: 40.0-48.0 percent
Optimal Adult Female Range: 37.0-44.0 percent
Red Flag Range <32.0 or >55 percent
Clinical Notes:
ƒSuspect Iron anemia if serum iron, hemoglobin and hemocrit are all low
ƒSuspect B-6 anemia if MCT, hemocrit and iron are low (also look for a low
SGOT)
ƒSuspect B12/folic acid anemia if you have a low hemocrit with a high
MCH, MCV and iron
Clinical Notes: Consider getting a ferritin test
PLATELETS
Platelets: Platelets are concerned with the clotting of the blood.
Clinical Adult Range: 150,000-450,000cu.mm
Optimal Adult Range: 200,000-300,000cu.mm
Red Flag Range <50,000 or >600,000cu.mm
Nutrition Tip: Low levels of Platelets may indicate a B12, folic, selenium and
iron deficiency
Clinical Notes: The following drugs have been found to lower Platelets:
quinidine, heparin, gold salts, sulfas, digitoxin
25RETICULOCYTE COUNT
Reticulocyte Count This is an excellent test to confirm chronic microscopic
bleeding
Clinical Adult Range: 0.5-1.5%
Optimal Adult Range: same as clinical range
Red Flag Range >2.0%
MCV
Mean Corpuscular Volume (MCV) The MCV indicates the volume occupied by
the average red blood cell
Clinical Adult Range: 81.0-99.0cu.microns
Optimal Adult Range: 82.0-89.9cu.microns
Red Flag Range <78.0 or >95.0cu.microns
Clinical Notes: If the MCV is >89.9 and the MCH is >31.9, suspect Vitamin B-12
or folic anemia. This should be confirmed with a serum or urinary methylmalonic
(vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6)
Clinical Notes: If iron, ferritin are normal and MCV, MCH, Hemoglobin and
Hematocrit are all decreased, suspect a toxic metal body burden
MCH
Mean Corpuscular Hemoglobin (MCH) The MCV indicates the volume
occupied by the average red blood cell
Clinical Adult Range: 26.0-33.0micro-micro grams
Optimal Adult Range: 27.0-31.9micro-micro grams
Red Flag Range <24.0 or >34.0micro-micro grams
26Clinical Notes: If the MCV is >89.9 and the MCH is >31.9, suspect Vitamin B-12
or folic anemia. This should be confirmed with a serum or urinary methylmalonic
(vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6)
Clinical Notes: If iron, ferritin are normal and MCV, MCH, Hemoglobin and
Hematocrit are all decreased, suspect a toxic metal body burden
T3
T3 (Tri-Iodothyronine): T-3 is a thyroid hormone produced mainly from the
peripheral conversion of thyroxine (T-4)
Clinical Adult Range: 22-33%
Optimal Adult Range: 26-30%
Common Causes of T3 Increase: Hyperthyroidism
Common Causes of T3 Decrease: Hypothyroidism
T4
T-4 (Tetra-Iodothyronine): T-4 is the major hormone secreted by the thyroid
gland.
Clinical Adult Range: 4.0-12.0mcg/dL
Optimal Adult Range: 7.0-8.5mcg/dL
T7
T7 (FTI-Free Thyroxine Index) FTI is an estimate, calculated from T-4 and T-3
uptake.
Clinical Adult Range: 4.0-12.0mcg/dL
Optimal Adult Range: 7.0-8.5mcg/dL
T-3 UPTAKE
T-3 Uptake T-3 uptake measures the unsaturated binding sites on the thyroid
bindng proteins
27Clinical Adult Range: 22-36%
Optimal Adult Range: 27-37%
Red Flag Range <20 percent of uptake or >39 percent of uptake
TSH
TSH (Thyroid Stimulating Hormone): is used to confirm or rule out suspected
hypothyroidism when T3, T4, T7 are essentially normal and clinical signs suggest
hypothyroidism
Clinical Adult Range: 0.4-4.4mlU/L
Optimal Adult Range: 2.0-4.0mlU/L
Red Flag Range <0.3mlU/L or >10.0mlU/L
Clinical Notes: The axillary temperature (underarm) will frequently be <97.8 with
thyroid hypo-function. The axillary temperature should be taken for 10 minutes
before leaving bed and ideally should be taken for five days in a row and
averaged. Reduced axillary temperature is common with adrenal stress, thiamine
deficiency, diets low in essential fatty acids and protein malnutrition
Clinical Notes: Difficulty losing weight, fatigue, lack of motivation, sensitivity to
cold, dry or scaly skin, ringing in ears, low blood pressure, impaired hearing,
constipation, difficulty working under pressure and headaches that start in the
morning but improve during the day.
ESR
ESR (Erythrocyte Sedimentation Rate): documents if organic disease is truly
present in patients with vague symptoms. Monitors the course of chronic
inflammatory conditions. Elevated in patients with breakdown of tissue
Clinical Adult Male <50 Range: 0-15mm/hour
Clinical Adult Male >50 Range: 0-20mm/hour
Clinical Adult Male <50 Range: 0-25mm/hour
Clinical Adult Female >50 Range: 0-30mm/hour
Optimal Adult Male Range: <5mm/hour
28Optimal Adult Female Range: <10mm/hour
Red Flag Range >45 mm/hour
I invite you to take a free tour of my site. Visit
http://www.yourmedicaldetective.com/...partment59.cfm
Take care,
Dr. Grisanti
adiyen srinivasan pranams
This is an article forwarded to me by a friend. i thought that this may be useful to our members.
The article has been cropped to accommodate only 30000 words. full article contains about 42000 words.
I could not attach the same as file.
regards
Srinivasan
The Simplified Patient Reference Guide
By Ronald J. Grisanti D.C.
2
GLUCOSE
Glucose: This is the chief source of energy for all living organisms. A level
greater than 105 in someone who has fasted for 12 hours suggests a diabetic
tendency. If this level is elevated even in a non-fasting setting one must be
concerned that there is a risk for developing diabetes. This is an incredibly
powerful test and can predict diabetes ten years or more before one develops the
strict definition of diabetes which is levels greater than 120.
Common Causes of Glucose Increase: Diabetes, poor carbohydrate utilization,
syndrome X
Clinical Adult Range: 70-115 mg/dL
Optimal Adult Range: 85-100 mg/dL
Red Flag Range <50 or >250 mg/dL
Clinical Notes: Order Glycohemoglobin (HGB A1C) with serum glucose values
above 160 and to monitor diabetics under therapy
Nutrition Tip: Thiamine Deficiency has been linked to increase in glucose
levels
6
SODIUM
Sodium: This element plays an important role in salt and water balance in your
body. A low level in the blood can be caused by too much water intake, heart
failure, or kidney failure. A low level can also be caused by loss of sodium in
diarrhea, fluid or vomiting. A high level can be caused by too much intake of salt
or by not enough intake of water.
Clinical Adult Range: 135-145
Optimal Adult Range: 140-144
Red Flag Range <125 or >155 mmol/L
POTASSIUM
Potassium: This element is found primarily inside the cells of the body. Low
levels in the blood may indicate severe diarrhea, alcoholism, or excessive use of
water pills. Low potassium levels can cause muscle weakness and heart
problems.
Clinical Adult Range: 3.5-5.0
Optimal Adult Range: 4.0-4.6
Red Flag Range <3.0 or >6.0 mmol/L
7MAGNESIUM
Magnesium: This important element is found in the arteries, heart, bone,
muscles, nerves, teeth.
Clinical Adult Range: 1.7-2.4
Optimal Adult Range: 2.2-2.6
Red Flag Range <1.2 mg/dL
Clinical Note: Magnesium should be evaluated on all patients suffering with
heart disease.
Clinical Note: Patient suffering with fibromyalgia may have a low serum
magnesium accompanied with a low C02 and an increased anion gap
Nutrition Tip: Excessive use of antacids containing magnesium may increase
magnesium levels
Clinical Note: If your magnesium is less than 2.0, it is strongly recommended to
have an erythrocyte magnesium test or a magnesium loading test
CHLORIDE
Chloride: Is an electrolyte controlled by the kidneys and can sometimes be
affected by diet. An electrolyte is involved in maintaining acid-base balance and
helps to regulate blood volume and artery pressure. Elevated levels are related
to acidosis as well as too much water crossing the cell membrane.
Clinical Adult Range: 96-110 mmol/L
Optimal Adult Range: 100-106 mmol/L
Red Flag Range <90 or >115 mmol/L
8Clinical Note: Suspect hypochlorhydria if chloride is below 100, the total globulin
is less than 2.4 and serum phosphorus is less than 3.0
Clinical Note: Chloride is required for the production of HCL by the chief cells of
the stomach
BLOOD UREA NITROGEN
BUN (Blood Urea Nitrogen): BUN is a waste product derived from protein
breakdown in the liver. Increases can be caused by excessive protein intake,
kidney damage, certain drugs, low fluid intake, intestinal bleeding, exercise, heart
failure or decreased digestive enzyme production by the pancreas. Decreased
levels are most commonly due to inadequate protein intake, malabsorption, or
liver damage.
Clinical Adult Range: 10-26 mg/dL
Optimal Adult Range: 13-18 mg/dL
Red Flag Range <5 or >50 mg/dL
Clinical Note: Decreased BUN less than 8 with a decreased urinary specific
gravity may indicate posterior pituitary dysfunction
Clinical Note: Increased BUN above 25 usually indicates kidney disease.
However, if Creatinine is not above 1.1, then kidney disease may not be the
problem. Instead consider anterior pituitary dysfunction, dehydration or
hypochlorhydria.
Nutrition Tip: Increased BUN may indicate a Boron deficiency
9CREATININE
Creatinine: Creatinine is also a protein breakdown product. Its level is a
reflection of the bodies muscle mass. Low levels are commonly seen in
inadequate protein intake, liver disease, kidney damage or pregnancy. Elevated
levels are generally reflective of kidney damage and need to be monitored very
carefully.
Clinical Adult Range: 0.7-1.5 mg/dL
Optimal Adult Range: 0.7-1.0 mg/dL
Red Flag Range >1.6 mg/dL
Clinical Note: Suspect early nephritis ( kidney disease) if creatinine is between
2-4 mg/dL. Suspect severe nephritis is creatinine is between 4-35 mg/dL
Common Causes of Creatinine Decrease: Amyotonia congenita
BUN/CREATININE RATIO
BUN/Creatinine Ratio: increased values may indicate catabolic states,
dehydration, circulatory failure leading to fall in renal blood flow, congestive heart
failure, acute and chronic renal (kidney) failure, urinary tract obstruction, prostatic
enlargement, high protein diet. Decreased values may indicate overhydration,
low protein/high carbohydrate diet, pregnancy
Clinical Adult Range: 6-10
Optimal Adult Range: 10-16
Red Flag Range <5 or >30
10URIC ACID
Uric Acid: Uric acid is the end product purine metabolism. High levels are seen
in gout, infections, high protein diets, and kidney disease. Low levels generally
indicate protein and molybdenum (trace mineral) deficiency, liver damage or an
overly acid kidney.
Clinical Female Range: 2.4-6.0 mg/dL
Clinical Male Range: 3.4-7.0 mg/dL
Optimal Female Range: 3.0-5.5 mg/dL
Optimal Male Adult Range: 3.5-5.9 mg/dL
Red Flag Range <2 mg/dL or >9.0 mg/dL
PHOSPHORUS
Phosphorus: Phosphorus is closely associated with calcium in bone
development. Therefore most of the phosphate in the body is found in the bones.
But the phosphorus level in the blood is very important for muscle and nerve
function. Very low levels of phosphorus in the blood can be associated with
starvation or malnutrition and this can lead to muscle weakness. High levels in
the blood are usually associated with kidney disease. However the blood must be
drawn carefully as improper handling may falsely increase the reading.
Clinical Adult Range: 2.5-4.5
Optimal Adult Range: 3.2-3.9
Red Flag Range <2.0 mg/dL or >5.0 mg/dL
11Less Common Causes of Phosphorus Decrease: Diabetes, liver dysfunction,
protein malnutrition, neurofibromatosis, myxedema
Nutrition Tip: Phosphorus is frequently decreased with diets high in refined
sugars
Clinical Note: Suspect Vitamin D deficiency with low levels of calcium,
phosphorus and increased levels of alkaline phosphorus
Clinical Note: Phosphorus is a general indicator of digestive function. Consider
hypochlorhydria when phosphorus is below 3.0 and total serum globulin is
greater than 3.0 or less than 2.4
CALCIUM
Calcium: Calcium is the most abundant mineral in the body. It is involved in
bone metabolism, protein absorption, fat transfer, muscular contraction,
transmission of nerve impulses, blood clotting, and heart function. It is highly
sensitive to elements such as magnesium, iron, and phosphorous as well as
hormonal activity, vitamin D levels, CO2 levels and many drugs. Diet, or even the
presence of calcium in the diet has a lot to do with "calcium balance" - how much
calcium you take in and how much you lose from your body.
Clinical Adult Range: 8.5-10.8
Optimal Adult Range: 9.7-10.1
Red Flag Range <7.0 mg/dL or >12.0 mg/dL
Clinical Note: Serum protein influences calcium levels. Calcium goes up with
increased protein and goes down with decreased protein
Clinical Fact: Poor intestinal fat absorption may be suspected with low levels of
calcium, bilirubin and phosphorus
Nutrition Note: Pancreatic enzyme deficiency may be suspected with low levels
of calcium, triglycerides and increased levels of LDH
12Clinical Note: Circadin rhythm abnormality should be a primary consideration
with calcium levels either above or below normal
ALBUMIN
Albumin: The most abundant protein in the blood, it is made in the liver and is
an antioxidant that protects your tissues from free radicals. It binds waste
products, toxins and dangerous drugs that might damage the body. Is also is a
major buffer in the body and plays a role in controlling the precise amount of
water in our tissues. It serves to transport vitamins, minerals and hormones.
Lower levels are seen in poor diets, diarrhea, fever, infections, liver disease,
kidney disease, third-degree burns, edemas or hypocalcemia.
Clinical Adult Range: 3.0-5.5
Optimal Adult Range: 4.0-4.4
Red Flag Range <4.0 g/dL
Clinical Note: Albumin 3.5 or below with a 1500 or less lymphocyte count is one
of the four OMINOUS signs
Nutrition Tip: Decreased albumin with decreased serum phosphorus may
indicate digestive inflammation
Calcium/Albumin Ratio: elevated in malnutrition or visceral protein loss.
Levels higher than 2.7 is one of the four OMINOUS signs
GLOBULIN
Globulin: Globulins have many diverse functions such as, the carrier of some
hormones, lipids, metals, and antibodies. High levels are found in chronic
infections, liver disease, rheumatoid arthritis, myelomas and lupus. Lower levels
may be seen in immune compromised patients, poor dietary habits,
malabsorption, liver and kidney disease.
Clinical Adult Range: 2.0-4.0
Optimal Adult Range: 2.8-3.5
Red Flag Range <2.0 g/dL or >3.5 g/100ml
A/G RATIO
A/G Ratio: is an important indicator of disease states. Low ratio suggests
ulcerative colitis, burns, kidney disease, cirrhosis, multiple myeloma.
A/G ratio less than 1.0 is one of the four OMINOUS signs
Clinical Adult Range: 1.1-2.5
Optimal Adult Range:1.2-1.5
Red Flag Range <1.0
Nutrition Note: Elevated A/G ratio, elevated protein and an elevated cholesterol
may indicate too high protein consumption
ALKALINE PHOSPHATASE
Alkaline Phosphatase: Alkaline phosphatase is an enzyme that is found in all
body tissue, but the most important sites are bone, liver, bile ducts and the gut. A
high level of alkaline phosphatase in your blood may indicate bone, liver or bile
duct disease. Certain drugs may also cause high levels. Growing children,
because of bone growth, normally have a higher level than adults do. Low levels
indicate low functioning adrenal glands, protein deficiency, malnutrition or more
commonly, a deficiency in zinc.
Clinical Adult Range: 30-115
Optimal Adult Range: 60-80
Red Flag Range <30U/L or >Laboratory range
Clinical Note: Any patient having a significant increase in Alkaline Phosphatase
should have a ALP isoenzyme
Clinical Note: It is considered ““NORMAL”” for Alkaline Phosphatase to be
elevated in children under 18 and people with bone fractures.
SGPT/ALT & SGOT/AST
Transaminases (SGTP/ALT) & (SGOT/AST): These are enzymes that are
primarily found in the liver. Drinking too much alcohol, certain drugs, liver disease
and bile duct disease can cause high levels in the blood. Hepatitis is another
problem that can raise these levels. Low levels of GGT may indicate a
magnesium deficiency. Low levels of SGPT and SGOT may indicate deficiency
of vitamin B6.
Clinical Adult Range: 0-41
Optimal Adult Range: 18-26
Red Flag Range >100 U/L
SGOT/AST is found in the heart, skeletal muscles, brain, liver and kidneys
Clinical Note: In acute congestive heart failure and/or myocardial infarction, the
SGOT/AST will significant increase. However, these values will slowly return to
normal. SGPT/ALT will also increase in these cardiac heart emergencies,
however, SGOT/AST normally will not return to normal as quick as SGPT
SGPT/ALT is found in the liver, kidneys, heart and skeletal muscles.
Common Causes of SGPT/ALT Increase: Acute hepatitis, cirrhosis of liver,
mononucleosis
Less Common Causes of SGPT/ALT Increase: Pancreatitis, biliary
dysfunction, diabetes
15Clinical Note: SGPT values are greater than SGOT in liver obstruction, toxic
hepatitis. SGOT values are greater than SGPT in cirrhosis of the liver, liver
neoplasms and jaundice
GGT
Gamma-Glutamyl transerase (GGT): Believed to be involved in the transport of
amino acids into cells as well as glutathione metabolism. Found in the liver and
will rise with alcohol use, liver disease, or excess magnesium.
Clinical Adult Range: 0-55U/L
Optimal Adult Range: 10-30U/L
Red Flag Range >90U/L
Common Causes of GGT Increase: Biliary obstruction, alcoholism,
cholangitis/cholecystitis (bile duct and gall bladder inflammation)
Clinical Note: If GGT is greater than 150 U/L with a serum bilirubin of over 2.8
mg/dL, strongly suspect biliary obstruction. Seek immediate medical attention
Clinical Note: If GGT values are five times higher than the clinical range suspect
pancreatitis
Less Common Causes of GGT Increase: Brucellosis, hepatitis, mononucleosis,
bacterial and viral infection, malignancy, congestive heart failure biliary.
Nutrition Note: Low levels of GGT may indicate a B-6 deficiency.
Additional Clinical Notes: Food allergy/sensitivity is a very common finding with
biliary dysfunction
LDH
Lactate Dehydrogenase (LDH): LDH is an enzyme found in all tissues in the
body. A high level in the blood can result from a number of different diseases
such as hepatitis, anemia etc. Also, slightly elevated levels in the blood are
common and usually do not indicate disease. The most common sources of LDH
are the heart, liver, muscles, and red blood cells.
Clinical Adult Range: 60-225U/L
Optimal Adult Range: 140-200U/L
Red Flag Range >250U/L
Common Causes of LDH Increase: Liver/biliary dysfunction, pulmonary
embolism, myocardial infarction, tissue inflammation, tissue destruction,
malignancy anywhere in the body, several types of anemias
Clinical Note: LDH will frequently increase with low thyroid function
Clinical Note: LDH is frequently increased with birth control usage
16Nutrition Note: Decrease LDH may indicate reactive hypoglycemia. (Check
glucose)
TOTAL PROTEIN
Total Protein: This is a measure of the total amount of protein in your blood.
Total protein is the combination of albumin and total globulin and is affected by
the albumin and total globulin. A low or high total protein does not indicate a
specific disease, but it does indicate that some additional tests may be required
to determine if there is a problem.
Clinical Adult Range: 6.0-8.5g/dL
Optimal Adult Range: 7.1-7.6g/dL
Red Flag Range <5.9g/dL or > 8.5g/dL
IRON
Iron: The body must have iron to make hemoglobin and to help transfer oxygen
to the muscle. If the body is low in iron, all body cells, particularly muscles in
adults and brain cells in children, do not function up to par. If this test is low you
should consider getting a Ferritin test, especially if you are a female who still has
menstrual cycles.
Clinical Adult Range: 40-150ug/ml
Optimal Adult Range: 50-100ug/ml
Red Flag Range <25ug/ml or >200ug/ml
Nutrition Note: Increased iron with decreased hemocrit (HCT) suggests intrinsic
factor deficiency
Clinical Notes: An iron evaluation is not complete without ordering Ferritin (see
below)
FERRITIN
Ferritin: This test is considered the "gold standard" in documenting iron
deficiency anemia. Low levels below 25 indicate a need for iron. High levels may
an inflammatory disorder, infections, rheumatoid arthritis, chronic kidney disease
Clinical Male Adult Range: 33-236ng/mL
Clinical Female Adult Range (before menopause): 11-122ng/mL
Clinical Female Adult Range (after menopause): 12-263ng/mL
Optimal Male Adult Range: 20-200ng/mL
Optimal Female Adult Range (before menopause): 10-110ng/mL
Optimal Female Adult Range(after menopause): 20-200ng/mL
Red Flag Range <8ng/mL or >500ng/mL
Clinical Notes: Serum ferritin greater than 1000 suspect hemochromatosis
Clinical Notes: Iron overload and/or hemochromatosis are silent and can result
in cirrhosis of the liver, bacterial infections, dementia, arteriosclerosis, diabetes
and stroke
Nutrition Note: Doctors specializing in chelation have found a correlation with
increased iron and arteriosclerosis.
TRIGLYCERIDES
Triglycerides: These are fats used as fuel by the body, and as an energy source
for metabolism. Increased levels are almost always a sign of too much
carbohydrate intake and hyperlipidism. Decreased levels are seen in
hyperthyroidism, malnutrition and malabsorption.
18Clinical Adult Range: 50-150mg/dL
Optimal Adult Range: 70-110mg/dL
Red Flag Range <35mg/dL or >350mg/dL
Clinical Notes: Resistive exercise training has been found to be effective in
lowering elevated triglycerides
CHOLESTEROL
Cholesterol: Group of fats vital to cell membranes, nerve fibers and bile salts,
and a necessary precursor for the sex hormones. High levels indicate diet high in
carbohydrates/sugars. Low levels indicate low fat diet, malabsorption, anemia,
liver disorders, carbohydrate sensitivity. Cholesterol values below 140 are
considered one of the four OMINOUS signs.
Clinical Adult Range: 120-200mg/dL
Optimal Adult Range: 150-180mg/dL
Red Flag Range <50mg/dL or >400mg/dL
Nutrition Note: Increased cholesterol levels have been found to be lowered by
the amino acid methionine
Clinical Notes: Cholesterol level below 130 is considered an Ominous sign
Clinical Notes: If cholesterol is above 220 with a SGPT below 10 suspect liver
congestion/fatty liver
LDL CHOLESTEROL
LDL Cholesterol: LDL is the cholesterol rich remnants of the lipid transport
vehicle VLDL (very-low density lipoproteins) there have been many studies to
correlate the association between high levels of LDL and arterial arteriosclerosis.
19Clinical Adult Range: <130mg/dL
Optimal Adult Range: <120mg/dL
Red Flag Range >180mg/dL
Nutrition Note: Increased cholesterol levels have been found to be lowered by
the amino acid methionine
HDL
HDL (High Density Lipoprotein): HDL or High-density lipoprotein is the
cholesterol carried by the alpha lipoproteins. A high level of HDL is an indication
of a healthy metabolic system if there is no sign of liver disease or intoxication.
the two mechanisms that explain how HDL offers protection against chronic heart
disease are that HDL inhibits cellular uptake of LDL and serves as a carrier that
removes cholesterol from the peripheral tissues and transports it back to the liver
for catabolism.
Clinical Adult Males Range: >50mg/dL
Clinical Adult Female Range: >55mg/dL
Optimal Adult Male Range: >55mg/dL
Optimal Adult Male Range: >60mg/dL
Red Flag Range <35mg/dL
Nutrition Note: Diets high in refined carbohydrates, lack of exercise and genetic
predisposition have been found to lower HDL
Clinical Notes: If HDL is decreased, triglycerides are greater than 50% of the
cholesterol value, LDL is increased and uric acid is increased rule out
arteriosclerosis
CHOLESTEROL/HDL RATIO
Cholesterol/HDL ratio: this ratio is an important marker for cardiovascular
health. A ratio <4.0 is considered adequate. A ratio <3.1 is ideal.
CO2
CO2: The CO2 level is related to the respiratory exchange of carbon dioxide in
the lungs and is part of the bodies buffering system. Generally, when used with
the other electrolytes, carbon dioxide levels indicate pH or acid/alkaline balance
20in the tissues. This is one of the most important tests that we measure. Most
people have too much acid in their body. If you garden you will know that it is
very difficult to grow plants in soil where the pH is incorrect. Our blood is similar
to soil in many respects and it will be difficult to be healthy if our body's pH is not
well balanced.
Clinical Adult Range: 24-32mmol/L
Optimal Adult Range: 26-30mmol/L
Red Flag Range <18mmol/L or >38mmol/L
Nutrition Note: Low levels of CO2 may indicate a need for thiamine (a B-
vitamin)
Clinical Notes: If CO2 is above 32mmol/L, a Pulmonary Function Test should is
warranted
WHITE BLOOD CELLS
White Blood Cell (WBC): White blood count measures the total number of white
blood cells in a given volume of blood. Since WBCs kill bacteria, this count is a
measure of the body's response to infection.
Clinical Adult Range: 4,500-11,000cu.mm
Optimal Adult Range: 5,000-8,000cu.mm
Red Flag Range <3,000cu.mm or >13,000cu.mm
Nutrition Note: Decreased WBC may indicate a need for Vitamin B-12, B-6 and
folic acid.
21Clinical Notes: An increase or decrease in total WBC in conjunction with a
lymphocyte count below 20 and serum albumin below 4.0 is a pattern frequently
seen in a developing neoplasm (tumor)
NEUTROPHILS
Neutrophils: elevated in acute infection
Clinical Adult Range: 35-65 percent of total WBC
Optimal Adult Range: 40-60 percent of total WBC
Red Flag Range <30 percent of total WBC or >80 percent of total WBC
MONOCYTES
Monocytes: elevated in bacterial infections, protozoal infections
Clinical Adult Range: 0-10 percent of total WBC
Optimal Adult Range: <7 percent of total WBC
Red Flag Range >15 percent of total WBC
Clinical Notes: Increased monocytes are frequently present with prostate
hypertrophy, ovarian and uterine dysfunction
Clinical Notes: An increase in monocytes with an increase in the basophils
(>1.0) and a mild increase of eosinophils (>3.0) may indicate intestinal parasites
LYMPHOCYTES
Lymphocytes: elevated in acute and chronic infections. Decreased in viral
infection and immune deficiency
Clinical Adult Range: 20-40 percent of total WBC
Optimal Adult Range: 25-40 percent of total WBC
Red Flag Range <20 percent of total WBC or >55 percent of total WBC
Clinical Notes: Suspect a viral infections when the lymphocytes increase to a
point that either equal or exceeds the neutrophil level
EOSINOPHILS
Eosinophils: Elevated in allergic conditions, skin diseases, parasitic diseases
Clinical Adult Range: 0-7 percent of total WBC
Optimal Adult Range: 0-3 percent of total WBC
Red Flag Range <20 percent of total WBC or >55 percent of total WBC
Common Causes of Eosinophils Increase: Allergic condition (asthma), food
sensitivities, parasitic infection
Less Common Causes of Eosinophils Increase: Chemical/heavy metal
toxicity, Hodgkin’’s dis ease, ovarian and bone tumors
BASOPHILS
Basophils: Elevated in Infections
Clinical Adult Range: 0-2 percent of total WBC
Optimal Adult Range: 0-1 percent of total WBC
Red Flag Range <5 percent of total WBC
Clinical Notes: Consider ordering a comprehensive stool and digestive test to
rule out intestinal parasites if the basophils are increased with no sign of
inflammation
23RED BLOOD CELLS
RBC (Red Blood Cells): made in the spleen. Reveals the oxygen carrying ability
of the blood.
Clinical Adult Male Range: 4.60-6.0 million cu/mm
Clinical Adult Female Range: 3.90-5.50 million cu/mm
Optimal Adult Male Range: 4.20-4.90 million cu/mm
Optimal Adult Female Range: 3.90-4.50 million cu/mm
Red Flag Range for Men <3.90 or >6.00 million cu/mm
Red Flag Range for Women <3.50 or >5.00 million cu/mm
Nutrition Tip: Low levels of RBC may indicate a need for B-12, B-6 and folic
acid
Clinical Notes: Consider checking iron and ferritin levels with low levels of RBC
HEMOGLOBIN
Hemoglobin: Hemoglobin provides the main transport of oxygen and carbon in
the blood. It is composed of "globin", a group of amino acids that form a protein
and "heme", which contains iron. It is an important determinant of anemia
(decreased hemoglobin) or poor diet/nutrition or malabsorption.
Clinical Adult Male Range: 13.5-18.0g/dL
Clinical Adult Female Range: 12.5-16.0g/dL
Optimal Adult Male Range: 14.0-15.0g/dL
Optimal Adult Female Range: 13.5-14.5g/dL
Red Flag Range <10.0 or >17g/dL
Nutrition Tip: Low levels of Hemoglobin may indicate a need for B-12, folic acid
and thiamine Clinical Notes: Consider checking iron and ferritin levels with low levels of
Hemoglobin
HEMATOCRIT
Hematocrit: Hematocrit is the measurement of the percentage of red blood cells
in whole blood. It is an important determinant of anemia (decreased), dehydration
(elevated) or possible overhydration (decreased).
Clinical Adult Male Range: 40.0-52.0 percent
Clinical Adult Female Range: 36.0-47.0 percent
Optimal Adult Male Range: 40.0-48.0 percent
Optimal Adult Female Range: 37.0-44.0 percent
Red Flag Range <32.0 or >55 percent
Clinical Notes:
ƒSuspect Iron anemia if serum iron, hemoglobin and hemocrit are all low
ƒSuspect B-6 anemia if MCT, hemocrit and iron are low (also look for a low
SGOT)
ƒSuspect B12/folic acid anemia if you have a low hemocrit with a high
MCH, MCV and iron
Clinical Notes: Consider getting a ferritin test
PLATELETS
Platelets: Platelets are concerned with the clotting of the blood.
Clinical Adult Range: 150,000-450,000cu.mm
Optimal Adult Range: 200,000-300,000cu.mm
Red Flag Range <50,000 or >600,000cu.mm
Nutrition Tip: Low levels of Platelets may indicate a B12, folic, selenium and
iron deficiency
Clinical Notes: The following drugs have been found to lower Platelets:
quinidine, heparin, gold salts, sulfas, digitoxin
25RETICULOCYTE COUNT
Reticulocyte Count This is an excellent test to confirm chronic microscopic
bleeding
Clinical Adult Range: 0.5-1.5%
Optimal Adult Range: same as clinical range
Red Flag Range >2.0%
MCV
Mean Corpuscular Volume (MCV) The MCV indicates the volume occupied by
the average red blood cell
Clinical Adult Range: 81.0-99.0cu.microns
Optimal Adult Range: 82.0-89.9cu.microns
Red Flag Range <78.0 or >95.0cu.microns
Clinical Notes: If the MCV is >89.9 and the MCH is >31.9, suspect Vitamin B-12
or folic anemia. This should be confirmed with a serum or urinary methylmalonic
(vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6)
Clinical Notes: If iron, ferritin are normal and MCV, MCH, Hemoglobin and
Hematocrit are all decreased, suspect a toxic metal body burden
MCH
Mean Corpuscular Hemoglobin (MCH) The MCV indicates the volume
occupied by the average red blood cell
Clinical Adult Range: 26.0-33.0micro-micro grams
Optimal Adult Range: 27.0-31.9micro-micro grams
Red Flag Range <24.0 or >34.0micro-micro grams
26Clinical Notes: If the MCV is >89.9 and the MCH is >31.9, suspect Vitamin B-12
or folic anemia. This should be confirmed with a serum or urinary methylmalonic
(vitamin B-12) and a serum or urinary homocysteine (folic acid and vitamin B-6)
Clinical Notes: If iron, ferritin are normal and MCV, MCH, Hemoglobin and
Hematocrit are all decreased, suspect a toxic metal body burden
T3
T3 (Tri-Iodothyronine): T-3 is a thyroid hormone produced mainly from the
peripheral conversion of thyroxine (T-4)
Clinical Adult Range: 22-33%
Optimal Adult Range: 26-30%
Common Causes of T3 Increase: Hyperthyroidism
Common Causes of T3 Decrease: Hypothyroidism
T4
T-4 (Tetra-Iodothyronine): T-4 is the major hormone secreted by the thyroid
gland.
Clinical Adult Range: 4.0-12.0mcg/dL
Optimal Adult Range: 7.0-8.5mcg/dL
T7
T7 (FTI-Free Thyroxine Index) FTI is an estimate, calculated from T-4 and T-3
uptake.
Clinical Adult Range: 4.0-12.0mcg/dL
Optimal Adult Range: 7.0-8.5mcg/dL
T-3 UPTAKE
T-3 Uptake T-3 uptake measures the unsaturated binding sites on the thyroid
bindng proteins
27Clinical Adult Range: 22-36%
Optimal Adult Range: 27-37%
Red Flag Range <20 percent of uptake or >39 percent of uptake
TSH
TSH (Thyroid Stimulating Hormone): is used to confirm or rule out suspected
hypothyroidism when T3, T4, T7 are essentially normal and clinical signs suggest
hypothyroidism
Clinical Adult Range: 0.4-4.4mlU/L
Optimal Adult Range: 2.0-4.0mlU/L
Red Flag Range <0.3mlU/L or >10.0mlU/L
Clinical Notes: The axillary temperature (underarm) will frequently be <97.8 with
thyroid hypo-function. The axillary temperature should be taken for 10 minutes
before leaving bed and ideally should be taken for five days in a row and
averaged. Reduced axillary temperature is common with adrenal stress, thiamine
deficiency, diets low in essential fatty acids and protein malnutrition
Clinical Notes: Difficulty losing weight, fatigue, lack of motivation, sensitivity to
cold, dry or scaly skin, ringing in ears, low blood pressure, impaired hearing,
constipation, difficulty working under pressure and headaches that start in the
morning but improve during the day.
ESR
ESR (Erythrocyte Sedimentation Rate): documents if organic disease is truly
present in patients with vague symptoms. Monitors the course of chronic
inflammatory conditions. Elevated in patients with breakdown of tissue
Clinical Adult Male <50 Range: 0-15mm/hour
Clinical Adult Male >50 Range: 0-20mm/hour
Clinical Adult Male <50 Range: 0-25mm/hour
Clinical Adult Female >50 Range: 0-30mm/hour
Optimal Adult Male Range: <5mm/hour
28Optimal Adult Female Range: <10mm/hour
Red Flag Range >45 mm/hour
I invite you to take a free tour of my site. Visit
http://www.yourmedicaldetective.com/...partment59.cfm
Take care,
Dr. Grisanti
Comment