Chapter 26 Labs General and Research (LABS)

26.1 Laboratory General

The following general laboratory measurements were performed:

  • Lipid panel
    • Triglycerides
    • Total cholesterol
    • HDL
    • LDL
    • CHOL/HDLC ratio
    • non-HDL cholesterol
  • Microalbumin, random urine
    • Random Urine Creatinine
    • Microalbumin
    • Microalbumin/creatinine ratio
  • Iron and total iron binding capacity
    • Iron, total
    • Iron binding capacity
    • % saturation
  • Comprehensive metabolic panel
    • Glucose
    • Urea nitrogen (BUN)
    • Creatinine
    • EGFR, non-African American
    • EGFR, African American
    • BUN/Creatinine ratio
    • Sodium
    • Potassium
    • Chloride
    • Carbon dioxide
    • Calcium
    • Protein, total
    • Albumin
    • Globulin
    • Albumin/globulin ratio
    • Bilirubin, total
    • Alkaline phosphatase
    • AST
    • ALT
  • CBC
    • WBC
    • RBC
    • Hemoglobin
    • Hematocrit
    • MCV
    • MCH
    • MCHC
    • RDW
    • Platelet count
    • Absolute neutrophils
    • Absolute lymphocytes
    • Absolute monocytes
    • Absolute eosinophils
    • Absolute basophils
    • Neutrophils
    • Lymphocytes
    • Monocytes
    • Eosinophils
    • Basophils
  • Compounds, proteins and hormones
    • C-reactive protein
    • Ferritin
    • Vitamin B-12
    • Insulin
    • TSH (thyroid stimulating hormone), 3rd generation
    • Estradiol
    • Testosterone
    • Free testosterone
    • Testosterone bioavailable
    • SHBG
    • Albumin serum
  • Vitamin D
    • Vitamin D, 25-OH, total
    • Vitamin D, 25-OH, D3
    • Vitamin D, 25-OH, D2

26.1.1 Endocrine Health:

Insulin: Insulin is a hormone that regulates blood glucose (blood sugar) and is released from the beta cells of the pancreas. High blood glucose, which typically happens after eating a meal, stimulates the release of insulin, whereas low blood glucose levels inhibits insulin release. Insulin levels measured while fasting can give information about the body’s sensitivity to insulin. This is a test that measures the amount of insulin in your blood.

  • Insulin Ideal range < 16 uIU/mL

Testosterone: Testosterone is a steroid hormone. It is produced primarily in the testes in males and in the ovaries in females. Alternative forms of testosterone are produced in the adrenal glands and may have similar effects to both sexes. Testosterone levels are important for normal growth and development, adult reproductive health, and contribute to a variety of physical features such as male-pattern hair growth. The range of normal testosterone levels depends on age and sex. The proportion of estradiol to testosterone is often an important health indicator.

  • Testosterone Ideal Range: 250 - 1100 NG/DL

Thyroid Stimulating Hormone (TSH): TSH is measured as a screening test for thyroid function. This test measures the amount of TSH in the blood. The measurement provides more information about endocrine health.

  • TSH Ideal Range: 0.4-4.5 MIU/L

26.1.2 Immune Health

White Blood Cells: White blood cells, also known as leukocytes, help fight infections. There are five major types of white blood cells: Basophils, Eosinophils, Lymphocytes (T cells and B cells), Monocytes, Neutrophils. This test counts the amount of white blood cells you have in your blood. Your body produces more white blood cells when you have an infection, allergic reaction, or if you are under stress.

  • WBC Ideal Range: 3.8 - 10.8 THOUS/MCL
  • Critical Ranges: < 2.5 or > 50.0

Red Blood Cells: Red blood cells contain hemoglobin, which carries oxygen. The amount of oxygen your body uses is dependent on the number of RBCs you have. This test counts the amount of RBCs in your blood.

  • RBC Ideal Range: 4.2 - 5.8 MILL/MCL

Hemoglobin: Hemoglobin is a protein in red blood cells that carries oxygen. This test measures how much hemoglobin you have in your blood.

  • Hemoglobin ideal range: 13.2 - 17.1 G/DL
  • Critical: <8.0 g/dL

Hematocrit: The hematocrit blood test measures the number of red blood cells and the size of red blood cells. It gives a percentage of red blood cells found in whole blood. This test is almost always ordered as part of a complete blood count.

  • Hematocrit ideal range: 38.5 - 50.0%
  • Critical: < 25.0%

Platelets: Platelets are blood cells produced in the bone marrow that help the blood clot. The number of platelets in your blood gives some information about the health of your bone marrow. This test measures the platelet count in your blood.

  • Platelets ideal range: 140 - 400 THOUS/MCL
  • Critical: <50 or > 749

26.1.3 Inflammation Health

C-Reactive Protein (CRP-high sensitivity): C-Reactive protein is a molecule whose quantity in blood rises with the degree of systemic or generalized inflammation in a person’s body. It does not indicate any specific infection or inflammatory process but is a marker for non-specific inflammation. Lower quantities are generally better.

  • CRP ideal range: < 0.79 mg/dL

26.1.4 Metabolic Health

Albumin: Albumin is the protein of the highest concentration in the plasma and is made in the liver. The amount of albumin in the blood is a general indicator of nutritional health. This test measures the amount of albumin within the serum of blood.

  • Albumin ideal range: 3.6 - 5.1 g/dL

Alkaline Phosphatase: Alkaline phosphatase is a protein found in all body tissues. Tissues with particularly high amounts of ALP include the liver, bile ducts, and bone. This test measures the amount of ALP in your blood and provides information relevant to liver and bone health.

  • Alkaline Phosphatase ideal range: 40 - 115 U/L

Alanine Transaminase (ALT): This test measures the amount of the liver enzyme ALT in the blood. The measurement provides additional information about liver health.

  • ALT ideal range: 9 - 60 U/L

Aspartate Aminotransferase (AST): AST is found in high concentration in heart muscle, liver cells, and skeletal muscle cells. This test provides additional information about liver health by measuring the amount of AST in the blood.

  • AST ideal range: 10 - 35 U/L

Bilirubin: Bilirubin is a product that results from the breakdown of hemoglobin. Its concentration in the blood is primarily an indicator of how well the liver and the gallbladder are functioning.

  • Bilirubin Ideal range: .2 - 1.2 mg/dL

Blood Urea Nitrogen (BUN): BUN is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen in the blood, which is a measure of kidney health.

  • BUN Ideal range: 7 - 25 mg/dL

Chloride: Chloride is a negatively charged molecule in the fluid outside the body’s cells. It works with other substances, including sodium, to help control the body’s fluid level and acid-base balance. This test measures the amount of chloride in the blood.

  • Chloride Ideal range: 98 - 110 mmol/L

Carbon Dioxide (CO2): CO2 levels in the blood are influenced by kidney and lung function. The kidneys are mainly responsible for maintaining the normal bicarbonate levels. This test provides information about your kidney and lung health by measuring the amount of carbon dioxide is in your blood, usually in the form of bicarbonate.

  • CO2 Ideal range: 21 - 33 mmol/L

Glucose: This test measures the amount of sugar (glucose) in the blood. The test may be used to diagnose or screen for diabetes and to monitor patients who have diabetes.

  • Glucose Ideal range: 65 - 99 mg/dL
  • Glucose Impaired fasting: < 50 or 100 - 126 mg/dL
  • Glucose Suspect diabetes: > 126 mg/dL

Potassium: Potassium helps nerves and muscles communicate. It also helps move nutrients into cells and waste products out of cells. This test measures the amount of potassium in the blood.

  • Potassium Ideal range: 3.5 - 5.3 mmol/L

Protein: This test is a rough measure of all the proteins found in the fluid portion of your blood. Specifically it looks at the total amount of two classes of proteins: albumin and globulin. This is a general measure of nutritional health.

  • Protein Ideal range: 6.2 - 8.3 g/dL

Sodium: This test measures the amount of sodium in the blood. The level of sodium in your blood is a balance between the sodium in the food and drinks you consume and the amount in urine excreted.

  • Sodium Ideal range: 135 - 146 mmol/L

Cholesterol: Cholesterol is a soft, wax-like substance found in all parts of the body. Your body needs a small amount of cholesterol to work properly. This test measures all the cholesterol and triglycerides in your blood.

  • Cholesterol Ideal range: 125 - 200 mg/dL
  • Cholesterol Borderline low: < 125
  • Cholesterol Borderline high: 200 - 239
  • Cholesterol High: > 240

Triglyceride: Triglycerides are a type of fat that is either made by your body or comes from the food you eat. When you eat, your body uses calories for immediate energy. Leftover calories are turned into triglycerides and stored in fat cells for later use. This test measures the amount of triglycerides in your blood.

  • Triglyceride Ideal range: < 150 mg/dL

High Density Lipoprotein (HDL): The main function of HDL is to help soak up excess cholesterol from the walls of blood vessels and carry it to the liver, where it breaks down and is removed from the body in the bile. Studies of both men and women have shown that the higher your HDL, the lower your risk of coronary heart disease, thus HDL is sometimes referred to as “good” cholesterol.

  • HDL Ideal range: > 39 mg/dL

Low Density Lipoprotein (LDL): This test measures how much LDL you have in your blood. LDL is a type of cholesterol. Too much LDL in the blood can clog arteries. This test is usually done to determine your risk for heart disease. The LDL test is usually done as part of a lipid analysis, which also check for total cholesterol, HDL, and triglycerides.

  • LDL Ideal range: < 130 MG/DL (CALC)
  • LDL Borderline high: 130 - 159
  • LDL High: 160 - 189
  • LDL Very high: > 190

26.1.5 Microvascular Health

Urine Microalbumin/Creatinine Ratio: Creatinine, a byproduct of muscle metabolism, is normally excreted into the urine on a consistent basis. Its level in the urine is relatively stable. Since the concentration (or dilution) of urine varies throughout the day, this property of creatinine allows its measurement to be used as a corrective factor in random urine samples. When a creatinine measurement is performed along with a random microalbumin, the resulting microalbumin/creatinine ratio approaches the accuracy of the 24-hour microalbumin test without the extended collection hassle.

  • Urine Microalbumin/Creatinine Ratio Ideal range: < 30 mcg/mg creatinine
  • Urine Microalbumin/Creatinine Ratio Microalbuminuria: 30 - 299
  • Urine Microalbumin/Creatinine Ratio Clinical Albuminuria: > 300

26.1.6 Nutrition Screen

25-hydroxy Vitamin D : This test that measures the amount of 25-hydroxy vitamin D in the blood. This test is the most accurate measure of the amount of vitamin D in the body. You can obtain vitamin D from supplements or by exposure to sunlight.

  • VIT-D Ideal range: 30 - 100 ng/mL
  • VIT-D Optimal: >=30 ng/mL
  • VIT-D Insufficiency: 20 - 30 ng/mL
  • VIT-D Deficiency: <20 ng/mL

Vitamin B-12: This test that measures the amount of Vitamin B-12 in your blood. A Vitamin B-12 level can tell us information about your nutritional health.

  • VIT B-12 Ideal range: 200 - 1100 PG/ML

Ferritin: The amount of ferritin in your blood (serum ferritin level) is directly related to the amount of iron stored in your body. Iron is important for producing red blood cells.

  • Ferritin Ideal range: 20 - 380 NG/ML

Serum Iron: This is another test that measures how much iron is in your blood.

  • Serum Iron Ideal range: 45 - 170 mcg/dL

26.1.7 Laboratory General - Data Fields:

  • LG URINECREAT
  • LG MICROALBUMIN

  • LG ALBUM CREAT RATIO

  • LG TOTCHOLESTEROL
  • LG HDL
  • LG TRIGLYCERIDES
  • LG LDL
  • LG CHOL HDLC RATIO

  • LG NON HDL CHOL

  • LG GLUCOSE
  • LG BUN
  • LG CREATININE
  • LG EGFR NAM
  • LG EGFR
  • LG BUN CREAT RATIO
  • LG SODIUM
  • LG POTASSIUM
  • LG CHLORIDE
  • LG CO2
  • LG CALCIUM
  • LG PROTEIN
  • LG ALBUMIN
  • LG GLOBULIN
  • LG ALB GLOB RATIO
  • LG BILIRUBIN
  • LG ALKPHOSPHATASE
  • LG AST

  • LG ALT

  • LG D25TOTAL
  • LG D25D2

  • LG D25D3

  • LG TSH

  • LG WHITEBLOODCELL
  • LG REDBLOODCELL
  • LG HEMOGLOBIN
  • LG HEMATOCRIT
  • LG MCV
  • LG MCH
  • LG MCHC
  • LG RDW
  • LG PLATELET
  • LG ABS NEUTHROPHILS
  • LG ABS LYMPHOCYTES
  • LG ABS MONOCYTES
  • LG ABS EOSINOPHILS
  • LG ABS BASOPHILS
  • LG NEUTHROPHIS
  • LG LYMPHOCYTES
  • LG MONOCYTES
  • LG EOSINOPHILS

  • LG BASOPHILS

  • LG TOT IRON CAPACITY
  • LG IRON CAPACITY

  • LG SATURATION

  • LG FERRITIN
  • LG B12
  • LG C CREATIVE
  • LG INSULIN
  • LG ESTRADIOL
  • LG TESTOSTERONE
  • LG FREE TESTOSTERONE
  • LG TESTOSTERONE BIOAVAIL
  • LG SHBG

  • LG ALBUMIN SERUM

26.2 Laboratory Research

The following research laboratory measurements were performed:

  • HPLC redox
  • MMP-9
  • 4-Plex Data
  • T-cell Data
  • CD34

26.2.1 Introduction to Research Biomarkers (from the Health Action Report)

Research biomarkers are a group of tests that measure four processes that we believe will provide new definitions of what health is and give clues to new things that can be done to maintain health. These four processes (oxidative stress, inflammation status, regenerative potential and immune health) are believed to be “generic” markers of health. They will detect very early changes long before any disease occurs, but they are not specific to any one disease. When these processes go awry, the end result might be cancer, heart disease, Alzheimer’s disease, diabetes, or cancer. If we are right, these measurements will become critical to health focused care. Your participation in the Center’s activities is helping in a very real way to develop research information to determine their usefulness.

We believe that measurements of inflammation, immune function, oxidative stress and regenerative potential will be better predictors of health than the things we are now using. We have some information to support that idea. In this section, we will summarize measurements of those processes in you and tell you what we know (and don’t know) about what these measurements mean at this point. As we discover further meaning of these tests, we will share that information with you.

26.2.2 Research Biomarkers

Oxidative Status (redox): All of our cells use oxygen for energy. Over time, some cellular processes can start to work improperly causing a condition called oxidative stress. This means that the cells are not fully converting oxygen to energy in the manner that they would in a completely healthy condition. Similar to a misfiring car engine, the fuel may not be used efficiently and harmful waste products can occur. The inefficient use of oxygen is measured in terms of being oxidized or reduced.

  • Cys Redox result given in mV

  • Typical range for healthy adults is -98 to -62 mV

  • GSH Redox results given in mV

  • Typical range for healthy adults is -155 to -121 mV

Inflammation Status: The immune system is important in providing protection against infections and plays a critical role in regulating healing responses. When called into action, immune cells cause inflammation through which they wall off and destroy infections and other abnormal conditions. If not regulated tightly, such inflammatory responses can turn against healthy tissues and cause a vast spectrum of chronic inflammatory diseases, such as rheumatoid arthritis, atherosclerosis, diabetes and Alzheimer’s disease. The immune system is composed of trillions of cells which can be easily accessed in a blood sample and analyzed in sophisticated assay systems. The composition of the immune system changes over time, influenced by infectious experiences and exposure to environmental challenges. A major factor in shaping the immune system is age, as the ability to rebuild and maintain immune cells changes over life time. A careful analysis of the immune system can therefore provide insights into life stresses and biologic effects of the aging process and can reveal subtle changes long before individuals actually get sick.

  • TNF-a usually analyzed and displayed as log(TNF-a)

Regenerative Potential: We each have the capacity to heal our organs and tissues from innate systems of repair. A key component of the innate repair system is the circulating precursor or stem cells that can be found circulating in the blood. These precursor cells can be isolated from your blood specimen and tested for activity. In general, a vigorous response to an injury or abnormal situation indicates a positive tendency toward being able to self-repair damages in tissues and organs.

  • CD34 cells results given in cells/uL

26.2.3 Laboratory Research - Data Fields:

  1. lr_cyss
  2. lr_cys
  3. lr_cysgsh
  4. lr_gsh
  5. lr_gssg
  6. lr_ehgsh
  7. lr_ehcys
  8. lr_total_cys
  9. lr_total_gsh
  10. lr_IL_6
  11. lr_tnf_a
  12. lr_IL-8
  13. lr_IFN-r
  14. lr_cd34
  15. lr_CD45+CD34+CD133+PERUL
  16. lr_CD45+CD34+CD133+VEGF2+MNC
  17. lr_CD45+CD34+CD133+VEGF2+CXCR4
  18. lr_CD45MEDFREQOFCD34
  19. lr_CD133+VEGF-ONCD45MED
  20. lr_CD133+VEGF+ONCD45MED
  21. lr_CD133-VEGF+ONCD45MED
  22. lr_CD133-VEGF-ONCD45MED
  23. lr_CD133+VEGF-ONCD34
  24. lr_CD133+VEGF+ONCD34
  25. lr_CD133-VEGF+ONCD34
  26. lr_CD133-VEGF-ONCD34
  27. lr_CD133+VEGF-ONMNCS
  28. lr_CD133+VEGF+ONMNCS
  29. lr_CD133-VEGF+ONMNCS
  30. lr_CD133-VEGF-ONMNCS
  31. lr_CD34+CD133+ONMNCS
  32. lr_CD34+CD133-ONMNCS
  33. lr_CD34-CD133-ONMNCS
  34. lr_CD34-CXCR4+ONMNCS
  35. lr_CD34+CXCR4+ONMNCS
  36. lr_CD34+CXCR4-ONMNCS
  37. lr_CD34-CXCR4-ONMNCS
  38. lr_CXCR4-VEGF+
  39. lr_CXCR4+VEGF+
  40. lr_CXCR4+VEGF-
  41. lr_CXCR4-VEGF-
  42. lr_CXCR4-CD133+ONMNCS
  43. lr_CXCR4+CD133+ONMNCS
  44. lr_CXCR4+CD133-ONMNCS
  45. lr_CXCR4-CD133-ONMNCS
  46. lr_CXCR4-VEGF+ONCD45MED
  47. lr_CXCR4+VEGF+ONCD45MED
  48. lr_CXCR4+VEGF-ONCD45MED
  49. lr_CXCR4-VEGF-ONCD45MED
  50. lr_CXCR4-CD133+ONCD45MED
  51. lr_CXCR4+CD133+ONCD45MED
  52. lr_CXCR4+CD133-ONCD45MED
  53. lr_CXCR4-CD133-ONCD45MED
  54. lr_CXCR4-VEGF+ONCD34
  55. lr_CXCR4+VEGF+ONCD34
  56. lr_CXCR4+VEGF-ONCD34
  57. lr_CXCR4-VEGF-ONCD34
  58. lr_CXCR4-CD133+ONCD34
  59. lr_CXCR4+CD133+ONCD34
  60. lr_CXCR4+CD133-ONCD34
  61. lr_CXCR4-CD133-ONCD34
  62. lr_CD34-VEGF+ONMNCS
  63. lr_CD34+VEGF+ONMNCS
  64. lr_CD34+VEGF-ONMNCS
  65. lr_CD34-VEGF-ONMNCS
  66. lr_CD34-CD133+ONMNCS
  67. lr_MMP-9/NGAL
  68. lr_Isoleucine
  69. lr_Valine
  70. lr_Urea
  71. lr_3-Hydroxybutyrate
  72. lr_Acetate
  73. lr_Acetone
  74. lr_Alanine
  75. lr_Citrate
  76. lr_Creatine
  77. lr_Creatinine
  78. lr_Formate
  79. lr_Glucose
  80. lr_Glutamate+Glutamine
  81. lr_1-Methylhistidine
  82. lr_Lactate
  83. lr_Leucine
  84. lr_Lysine
  85. lr_Ornithine
  86. lr_Phenylalanine
  87. lr_Proline
  88. lr_Pyruvate
  89. lr_Serine
  90. lr_Succinate
  91. lr_Tryptophan
  92. lr_Tyrosine
  93. lr_CD3+CD8+CELLS/UL
  94. lr_CD3+CD4+CELLS/UL
  95. lr_CD3+CELLS/UL