Reading Your Lab Test Results: Your Blueprint to Better Health!

Reading Your Lab Test Results – Here are 2 of the most common types of blood tests and what they can tell the doctor about your Health: the complete blood count (CBC) and the chemistry panel.

Some people find it helps to ask for a copy of their lab test results and have a member of their health care team go over the numbers with them. By getting a copy, you can also see what the normal ranges are for the lab that tested your blood and where your numbers fall within that range.

Reading Your Lab Test Results

Complete blood count (CBC)

The most common lab test that you’ll have done during treatment is called a complete blood count, or CBC. Blood is made up of water, proteins, nutrients, and living cells. A CBC tells your health care team about the cells in your blood. It measures 3 basic types of blood cells:

• Red blood cells
• White blood cells
• Platelets

Each of these cells has a special purpose. And each can be harmed by cancer and cancer treatments.

Reading Your Lab Test Results: Red blood cells (RBCs)

RBCs carry oxygen to and carbon dioxide away from the cells in your body. The CBC measures red blood cells in many ways, but the simplest measure is either

Hemoglobin (Hgb), the part of each RBC that carries iron

or

Hematocrit (Hct), the percent of RBCs in the blood

When the Hgb and Hct values fall too low, it’s called anemia .

Reading Your Lab Test Results: Platelets (Plts)

Platelets help control bleeding. You may bruise or bleed easily when your platelet levels are low. The risk of bleeding goes up when platelet levels drop below 20,000.

When your platelet count is low, your health care team may call it thrombocytopenia.

White blood cells (WBCs)

WBCs fight infection. There are many types of white blood cells and each fights infection in a special way.

The most important infection-fighting WBC is the neutrophil. The number doctors look at is called yourabsolute neutrophil count (ANC). A healthy person has an ANC between 2,500 and 6,000.

The ANC is found by multiplying the WBC count by the percent of neutrophils in the blood. For instance, if the WBC count is 8,000 and 50% of the WBCs are neutrophils, the ANC is 4,000 (8,000 × 0.50 = 4,000).

When the ANC drops below 1,000 it is called neutropenia. Your doctor will watch your ANC closely because the risk of infection is much higher when the ANC is below 500.

Chemistry panel

Another type of blood testing looks at blood chemistry. Chemistry panels may also be called by other names, such asmetabolic profile or blood chemistry profile. One blood sample can be used to measure many things like:

• Fats (lipids)
• Proteins
• Sugar (glucose)
• Electrolytes (like potassium, magnesium, sodium, and calcium)
• Enzymes

Certain blood chemistry tests can show how well your organs are working. For instance, liver function studies tell your doctor how well your liver is working. Other tests look at how well your kidneys are working. The chemistry panel may also show other problems with body function.

Some treatments can cause changes in your body’s blood chemistry, such as a drop in the amount of potassium in your blood. Your blood chemistry balance can also be changed by dehydration (not enough fluid in the body), which may be caused by nausea, vomiting, or diarrhea. Your doctor will order blood chemistry tests if there is concern that you may have any of these problems.

If the tests show that certain electrolytes are too low, your doctor may decide to replace them. If the tests show you are dehydrated, you may be given intravenous (IV) fluids. It’s important to have all the tests your doctor orders because most of the time you won’t have any symptoms until one or more blood chemistry values are dangerously low or high.

How to find normal values

Each lab has its own range for what it considers normal values for complete blood counts and chemistry panel results. What’s normal for one lab might not quite be normal for another, so it’s important to know what your lab’s normal range is when looking at your results. Normal ranges for some tests also vary by age and gender. As a rule, the normal ranges are printed on the lab report, next to your test results.

Common terms and numbers you may see on a CBC report and what they mean are on this chart:

Test	Units*	Normal values#	Comments
WBC (white blood cells)	x 1000/mm3	5–10	Number of infection-fighting cells
RBC (red blood cells)	x 1,000,000/mm3	4.2–6.1	Number of RBCs
Hgb (hemoglobin)	g/dL	12–18	Measure of RBCs, which carry oxygen and carbon dioxide
Hct (hematocrit)	%	37–52	Percentage of blood made up of RBCs
Plt (platelets)	x 1,000/mm3	150–450	Number of platelets. This number helps show risk of bleeding

*Note that results are often given in short form, as shown on this table. For instance, a WBC result may be shown as 6.2 rather than 6,200, which is why the Units column shows multiplying by 1000 (x 1000), sometimes abbreviated as K. RBCs are often shown as multiples of a million, sometimes abbreviated as M. The /mm3 stands for cubic millimeter, which is the same as µL (microliter). Grams is shown by the letter g, and dL means deciliter.

# These number ranges vary somewhat among labs.

Here’s an example of CBC test results, in a person with anemia, or a low hemoglobin and hematocrit:

Test	Result	Reference range#	This result may also be listed as
WBC (white blood cells)	6.2 x 1000/mm3	5–10	6.2K/mm3 or 62,000/mm3  6.2K/µL or 62,000/µL
RBC (red blood cells)	4.4 x 1,000,000/mm3	4.2–6.1	4.4M/mm3 or 4,400,000/ mm3 4.4M/µL or 4,400,000/µL
Hgb (hemoglobin)	9 g/dL (L)	12–18
Hct (hematocrit)	28% (L)	37–52
Plt (platelets)	178 x 1000/mm3	150–450	178K/mm3 or 178,000/mm3 178K/µL or 178,000/µL

# These number ranges vary somewhat among labs.

Results that are high or low might have the letter (H) or (L) after the number, or may be printed to the side or in a different column to call attention to the abnormal result.

Again, getting a copy of your lab results lets you compare your numbers to the normal ranges and makes it easier to ask questions about the results and what they mean.

Unless noted, all values are for adults

Albumin	3.2 – 5 g/dl
Alkaline phosphatase(Adults: 25-60)	33 – 131 IU/L
Adults > 61 yo:	51 – 153 IU/L
Ammonia	20 – 70 mcg/dl
Bilirubin, direct	0 – 0.3 mg/dl
Bilirubin, total	0.1 – 1.2 mg/dl
Blood Gases
	Arterial	Venous
pH	7.35 – 7.45	7.32 – 7.42
pCO2	35 – 45	38 – 52
pO2	70 – 100	28 – 48
HCO3	19 – 25	19 – 25
O2 Sat %	90 – 95	40 – 70
BUN	7 – 20 mg/dl
Complete blood count (CBC)  Adults
	Male	Female
Hemoglobin (g/dl)	13.5 – 16.5	12.0 – 15.0
Hematocrit (%)	41 – 50	36 – 44
RBC’s ( x 106 /ml)	4.5 – 5.5	4.0 – 4.9
RDW (RBC distribution width)	< 14.5
MCV	80 – 100
MCH	26 – 34
MCHC %	31 – 37
Platelet count	100,000 to 450,000
Creatine kinase (CK) isoenzymes
CK-BB	0%
CK-MB (cardiac)	0 – 3.9%
CK-MM	96 – 100%
Creatine phosphokinase (CPK)	8 – 150 IU/L
Creatinine (mg/dl)	0.5 – 1.4
Electrolytes
Calcium	8.8 – 10.3 mg/dL
Calcium, ionized	2.24 – 2.46 meq/L
Chloride	95 – 107 mEq/L
Magnesium	1.6 – 2.4 mEq/L
Phosphate	2.5 – 4.5 mg/dL
Potassium	3.5 – 5.2 mEq/L
Sodium	135 – 147 mEq/L
Other
Ferritin (ng/ml)	13 – 300
Folate (ng/dl)	3.6 – 20
Glucose, fasting  (mg/dl)	60 – 110
Glucose (2 hours postprandial)  (mg/dl)	Up to 140
Hemoglobin A1c	<6% of total HbAACE Guidelines (2011) Hemoglobin A1c, % (as a screening test) 5.4 – Normal ————————- 5.5-6.4 – High risk/prediabetes; requires screening by glucose criteria ————————- 6.5 -Diabetes, confirmed by repeating the test on a different day ================= In general, therapy should target a A1C level of 6.5% or less for most nonpregnant adults.
Iron  (mcg/dl)	65 – 150
Lactic acid (meq/L)	0.7 – 2.1
LDH (lactic dehydrogenase)	56 – 194 IU/L
Lipoproteins and triglycerides
Cholesterol, total	< 200 mg/dl
HDL cholesterol	35 mg/dL. Negative risk factor:   60 mg/dL
LDL cholesterol	65 – 180 mg/dl
Triglycerides	Normal: < 150 mg/dL.Borderline-high: 150 to 199 mg/dL High: 200 to 499 mg/dL Very High: >499 mg/dL
Osmolality	289 – 308 mOsm/kg
SGOT (AST)	< 35 IU/L  (20-48)
SGPT (ALT)	<35 IU/L
Testosterone – total (serum)	Male: 300 to 1000 ng/dLFemale: < 62 ng/dLALT: Male: 14-15 yr: 33-585 ng/dL 16-17 yr: 185-886 ng/dL 18-39 yr: 400-1080 ng/dL 40-59 yr: 350-890 ng/dL > 60 yr: 350-720 ng/dL Tanner Stage IV: 165-854 ng/dL Tanner Stage V: 194-783 ng/dL
Thyroid Function tests
Thyroid Function Testing Thyroid Function Test Measurement Normal Range Total T4 (TT4) bound and free T4 4.5 -11.5 ug/dL Free T4 (FT4) free T4 0.8 -2.8 ng/dL Free T4 Index (FT4I) estimate of free T4FT4I = TT4 x RT3U 1.0 -4.3 U Total T3 (TT3) bound and free T3 75 -200 ng/dL Resin T3 Uptake (RT3U) binding capacity of TBG 25 -35% TRH TRH 5 -25 mIu/mL TSH TSH 0.5 – 4.70 µIU/mLAmerican Association of Clinical Endocrinologists guidelines changed their normal range for TSH to0.3 – 3.04 mIU/L. Thyroglobulin Thyroglobulin 5-25 ng/mL Radioactive Iodine Uptake (RAIU) Distribution of radiolabeled iodine in the thyroid 5 hr – 5 to 15%24 hr – 15 to 35% Notes: Free T4 – much more useful then total T4 (e.g. interested in unbound or active form).  Total T4 not commonly measured. Greatly affected by TBG.  Free T4 index: indirect measure of free T4. Corrects for high/low values of TBG. Total T3: not as useful as free T3, however, may be useful in locating problems with TBG, or if looking for problems with peripheral conversion of T4 to T3.  Resin T3 Uptake: if low, then TBG binding capacity is high. Opposite if high. TSH: best measure to determine thyroid function.  Thyroglobulin: nonspecific test that is elevated when the thyroid gland is inflamed or enlarged.
Free T3	2.3-4.2 pg/ml
Total iron binding capacity (TIBC)	250 – 420  mcg/dl
Transferrin	> 200 mg/dl
Uric acid    (male)	2.0 – 8.0 mg/dl
(female)	2.0 – 7.5 mg/dl
WBC + differential
WBC (cells/ml)	4,500 – 10,000
Segmented neutrophils	54 – 62%
Band forms	3 – 5%  (above 8% indicates left shift)
Basophils	0 – 1   (0 – 0.75%)
Eosinophils	0 – 3   (1 – 3%)
lymphocytes	24 – 44  (25 – 33%)
Monocytes	3 – 6   (3 – 7%)
Absolute Neutrophil Count  (ANC) – Oncology
Equations: (1) Segs and bands reported as a percentage: WBC * ((segs / 100) + (bands / 100)) (2) Segs and bands reported in total numbers: WBC * (segs + bands) Neutrophils (aka polymorphonuclear cells, PMNs, granulocytes, segmented neutrophils,  or segs) fight against infection and represent a subset of the white blood count. Neutropenia by definition is an ANC below 1800/mm3 (some sources use a lower value). Absolute neutrophil count (ANC) of 1000-1800: Most patients will be given chemotherapy in this range. Risk of infection is considered low. Mild neutropenia – Absolute neutrophil count (ANC) of 500-1000: Carries with it a moderate risk of infection. Absolute neutrophil count (ANC) of less than 500: Severe neutropenia – high risk of infection. Remember that a reduced WBC is known as leukopenia. The WBC consists of the following (differential): Lymphocytes: 20-40% Neutrophils: 50-60% Basophils: 0.5-2% Eosinophils: 1-4% Monocytes: 2-9% (average: 4%). ANC = Total WBC x (% “Segs” + % “Bands”) Equivalent to: WBC x ((Segs/100) + (Bands/100)) The ANC refers to the total number of neutrophil granulocytes present in the blood. Normal value: 1500 cells/mm3. Mild neutropenia: 1000 – <1500/mm3. Moderate neutropenia: 500 – <1000/mm3. Severe neutropenia: < 500/mm3. Reference: Ayalew Tefferi, MD, ed. Primary Hematology. Totowa, NJ: Humana Press, 2001

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Thank you very much for reading Your Lab Test Results, hopefully useful.