Medical Blood Test Results: The Good, the Bad and the Ugly
You go see your doctor for your annual checkup.
A big part of that is bloodwork – the tests your doctor orders, depending on your age, your symptoms, your past and your present conditions.
We understand the general concept that the results of these tests are like a report card on our current health.
But the results are far more complicated than simply F, D, C, B or A.
And, of course, the results are more directly important. Making the “high honor roll” means you get to live longer and healthier. Flunk the wrong test, and your doctor may admit you to the hospital.
Most health-conscious people know about blood pressure, cholesterol and a few other common biomarkers, but what’s the test for ferritin?
How much is too much or too little? What’s it matter?
This report is a guide for patients who wish to learn how to take responsibility for their own health and anti-aging lifestyle results.
When you learn what the test results mean, and where you stand today, you’re more motivated to change your lifestyle so you improve your test results at your next visit.
Are Your Results “Normal” or “Optimal” – or Both?
Doctors, including medical researchers, often use the term “normal” as an implicit synonym for “healthy” or even “optimal.”
“Your cholesterol is normal,” your doctor says, clearly pleased and expecting you to sigh with relief.
But we live in a society where cardiovascular health problems are the Number One cause of death.
It’s “normal” to die of a heart attack. Clearly, that’s not “optimal” or even “healthy.”
So, do you really want one of the most critical markers for heart disease to be close to everybody else’s?
But do we even know what’s optimal? For many of these tests, I suspect not. Doctors know when a test result is “clinically significant” – that is, when it’s so bad something needs to be done. Or when a result indicates a problem, and they must order more tests to find out what the problem is.
But, in many cases, there’s a sort of gray zone between “not optimal” and “write a prescription.” Sort of like what has now become “prediabetes” and “prehypertension.” The “pre” may mean no medication, but it’s not optimal. It’s a sign you need to improve your diet, physical movement, sleep and other lifestyle behaviors.
“Pre” means the trend is NOT your friend. If you don’t change course, eventually you’ll slide from “pre” into the actual clinical disease.
Some tests may help your doctor get an overall picture of your current state of health, but not be critical in themselves.
However, for many tests, a normal result does mean simply that you’re within the range of good health.
We All Have “Goldilocks” Biologies
In popular culture, we assume “more is always better.”
More food, more money, more friends, more cars, more points in games and so on.
So we often confuse “more” with “better” when thinking of our health and bodies.
We often assume more inches is better than fewer inches, but the tallest man in history, Robert Wadlow, died at age 22 (and was still growing). Andre the Giant died of a heart attack at age 46.
Dwarves have problems too, so we seek the happy medium.
We don’t want too much fat or too little.
We don’t want too much calcium or too little.
For most tests, you want results that fall into the range of good health. Not too much, not too little.
The question becomes, do your test results fall in that optimal range?
The Right Biochemical in the Right Place
Just as our bodies are too complicated for a simplistic “more is better” approach, so too when it comes to WHERE things are in your body.
For example, we need calcium – in our bones and teeth, and some in our blood, but NOT stuck to the lining of our arteries, where it forms dangerous plaque that can cause a heart attack.
We need water almost everywhere in our cells – but NOT in the air sacs in our lungs, where it’s called “drowning.”
Your Doctor has the Final Word
The tests cover a broad range of conditions. Maybe you have a specific liver problem or a broad problem such as high blood pressure.
Your doctor is best able to evaluate the test results combined with everything else they know about you, to estimate the relative risks.
Also, the meaning of some test results remain either controversial (some online health gurus deny the importance of cholesterol in causing heart disease) or indeterminate (how much has modern medicine really researched ferritin?).
This information pertains only to fully grown adults. Children have their own special needs. It also places more emphasis on the needs of older adults. Most younger adults probably test healthier than they really are, because their unhealthy lifestyle habits haven’t yet had time to degrade their bodies. The trend is not their friend, but they’re still young enough to have a large cushion of safety. (Little do they know how fast time erodes that cushion.)
If you are one of the few 20 to 30 year-olds with cancer or heart disease, follow your doctor’s advice.
Tests for All Adults
I. Vital Signs
1. Weight
Okay, it’s not a blood test, but it’s important. That’s why weighing you is the first thing they do after they call you out of the waiting area.
But the significance of your weight in pounds depends on your height. The two figures together are used to calculate your Body Mass Index (BMI).
BMI has a few limitations, but it’s a handy tool for quantifying what we all know from looking at ourselves in a mirror.
That is, whether you’re underweight, about right or overweight.
The BMI is calculated by dividing your weight in kilograms by your squared height in meters.
BMI = kg/m^2
(NOTE: A kilogram is 2.2 pounds.)
(NOTE: A meter is 3.281 feet.)
Example:
You’re six feet tall and weigh 240 pounds.
240 / 2.2 = 109 kg
6 feet / 3.281 = 1.83 meters
1.83 X 1.83 = 3.35
109 / 3.35 = 32.5
Your BMI is 32.5
There’re many online calculators that make this simple, though many still want kilograms and meters. The American Cancer Society has one using pounds and feet / inches.
BMI Results
1. < 18.5 means you’re underweight
2. 18.5 to 24.9 means you’re normal weight
3. 25 to 29.9 means you’re overweight
4. > 30 means you’re obese
Of course, this doesn’t apply to people who’re pregnant or still recovering from childbirth.
It also doesn’t apply to bodybuilders and other athletes with large amounts of muscle. Muscle is dense tissue. It weighs so much, athletes may score as overweight or even obese even though they aren’t.
Let’s be real. Although the BMI is a useful tool for your doctor, you already know whether your weight is too little, just right, too much or way too much.
And if you’re pregnant or a dedicated athlete with much more muscle than fat, you know that too.
For most of us, BMI is a useful though limited indicator.
If your doctor ever wants to know your precise muscle tissue versus fat tissue percentages, the necessary tool is a DEXA scan. But it is invasive because it exposes you to radiation, so you don’t want one unless it’s necessary.
2. Temperature
Our temperatures vary around the traditional 98.6 degrees Fahrenheit. Some people are naturally cooler or warmer than others.
95 F (36 C) is hypothermia – dangerously low.
96 F (35.5 C) to 97.7 F (36.5 C) may be normal for some, but is too low for most of us.
97.8 F (36.5 C) to 99.5 F (37.5 C) is normal.
100.4 F (38C) and above usually indicates illness.
3. Resting Heart Rate
This one is complicated to evaluate. At any given moment, your heart rate can vary depending on what you’re doing, when you last exercised, when you last ate, how much and how well you slept the night before, your emotional state and so on.
It’s also highly influenced by your level of general fitness.
Also, we can’t link any specific heart rate – within the normal range – to a specific health risk or benefit.
Modern medicine says most adults have heart rates between 55 to 100 beats per minute.
Highly trained endurance athletes can have heart rates as low as 40 bpm.
If you are training to increase your aerobic and endurance capacity, keeping tracking of your heart rate can, over time, monitor your improvement.
However, if your resting heart rate falls below 60 beats per minute even though you’re not a well-trained endurance athlete, that could be bradycardia – a heart beat that’s too slow. That can result in such symptoms as fatigue, shortness of breath, chest pain, fainting and dizziness.
Tachycardia is the opposite problem. Your heartrate is over 100 bpm. This can be caused by arrhythmias or irregular heart rhythms.
4. Oxygen Saturation
This measures how much oxygen your blood is holding, and it’s expressed as a percentage.
95% to 99% is normal and healthy.
If you’re below 95%, that could indicate you have an active illness.
If you’re at 100%, while that may sound good, it’s actually not. It means your cells are not getting oxygen from your blood.
This is more of a marker of your current state rather than an indicator of your long-term health or lack of it.
5. Blood Pressure
Although blood pressure readings can be affected by many factors and variables, the test is so important doctors want to see it.
Despite the difficulties involved in getting one standard, consistent reading, your blood pressure is the single most important risk factor we have.
We measure two points within a heart beat’s cycle:
1. Your blood’s pressure when your heart thumps.
That’s the systolic, or the upper figure. It’s the higher one because your heart pumping increases the pressure.
2. Your blood’s pressure when your heart is between beats.
That’s the diastolic, or the lower figure. It’s lower because your heart is not actively pushing to increasure the pressure. It’s between beats.
Your blood is a thick fluid moving through your 60,000 miles of veins, arteries and capillaries.
That puts pressure on the walls of your blood vessels. When the amount of that pressure is relatively low, your blood vessels are designed to accomodate it, so that’s healthy.
But when the force of that pressure grows too strong, it stresses your blood vessels past their healthy capacity, weakening them and your heart.
Blood in your arteries is often compared to water in a garden hose. When the pressure is reasonable, that’s fine for the garden hose.
But if the hose becomes old and weak, with thin walls, then water running through it at high pressure can blow a hole in the hose.
That’s the equivalent in us of suffering a stroke or heart attack or an aneurysm. High blood pressure can also damage your brain, your sexual function and your kidneys. It’s why people require renal dialysis.
Even if you never suffer such a dramatic event, high blood pressure over time stresses and weakens your blood vessels. It also damages your heart and causes metabolic syndrome. It increases risk of dementia and cognitive decline.
Blood pressure is such an important marker, it’s continuously studied. In the past 40 years, the criteria have often been revised downward. Just in September 2025, the American Heart Association and the American College of Cardiology released new guidelines on hypertension.
A. Under 90 / under 60 – blood pressure is too low. You may feel faint, tired or dizzy.
B. 90 to 119 / 60 to 79 – this is called “normal” because it’s what the medical experts now say is the optimal blood pressure.
This is probably the clearest example of how doctors can confuse us by calling what’s optimal “normal.” Although most young adults are below 120/80, only about 5% of older adults meet this criteria. I believe it’s optimal, but hardly “normal” in a statistical sense.
C. 120 to 129 / under 80 – elevated blood pressure.
D. 130 to 139 / OR 80 to 89 – Stage One High Blood Pressure
E. > 140 / OR > 90 – Stage Two High Blood Pressure
F. > 180 OR > 120 – a medical emergency.
Clearly, these criteria are stricter than past guidelines, which called 140/90 normal.
Just as clearly, you should take them seriously. Whether or not you need medication is for you and your doctor to discuss.
But if you’re in the majority whose pressure is over 120/80, it’d be a good idea to evaluate how you can change your lifestyle to one that’s more heart healthy.
II. Tests Regarding Iron Including Iron Profile W/IBC (Iron Binding Capacity)
1. Ferritin
Ferritin is a protein that stores iron inside your cells. This test measures how much of the protein is in your blood, as a marker for how much iron you have stored in reserve.
Although this test isn’t as wellknown as others, it’s still serious. You need sufficient quantities of iron, but not too much. Having too little or not enough can lead to poor health consequences.
About 70% of the iron in our bodies is contained within the hemoglobin in our red blood cells. That is, hemoglobin and its iron are necessary for transporting oxygen from our lungs to all our cells. Ferritin is also required to make new blood cells. That’s why symptoms of iron-poor blood are weakness, pain and fatigue.
Low levels of ferritin combined with low counts of blood cells is iron-deficiency anemia.
Women who are menstruating tend to have lower amounts of iron because of the blood they lose every month. They’re more likely to be at risk of having too little iron in their blood.
High ferritin levels are linked to higher inflammation, high hemochromatosis and liver disease.
Normal Ranges
Men: 30 to 566 nanograms per milliliter (ng/mL)
Women: 15 to 205 nanograms per milliliter (ng/mL)
If you’re over 1,000 ng/mL, you probably have a serious medical condition.
If you fall on the low side, your doctor may talk to you about potential causes (recent blood losses) and iron-rich foods to eat.
2. Iron Profile W/IBC
IBC stands for “Iron Binding Capacity.”
The main protein that binds to iron in your blood is transferrin.
This set of tests complements ferritin, to determine how well your body is dealing with, using and storing iron. It helps with iron-related conditions. That includes iron overload (hemochromatosis), liver disease, kidney disease and anemia.
It looks at:
1. Iron
This is how much iron is circulating within your bloodstream.
Normal range: 50 to 150 mcg/dL
2. Transferrin saturation (TSAT)
The amount of iron bound to transferrin, as a percentage
Normal range: 20% to 50%
3. TIBC
Transferrin Iron Binding Capacity.
This is the highest amount of iron your transferrin can bind to.
Normal range: 250 to 400 mcg/dL
Factors that affect test results can include such medications as oral contraceptives, iron supplements, pregnancy, menstruation and liver disease.
Iron is definitely one of those elements we need in Goldilocks amounts.
Too little means our red blood cells can’t transport enough oxygen to our cells.
Too much iron can mean liver and heart problems. Also: joint pain, diabetes and fatigue.
III. Thyroid Gland Tests
1. T4 FREE or FT4
T4 is thyroxine, the main hormone your thyroid gland produces.
This test measures how much T4 is free – that is, bound, not attached to any protein – in your blood.
There is a test to measure the total T4 in your body, but experts believe measuring free T4 is a more useful tool.
Having too little or too much T4 may indicate a problem with your thyroid gland.
Your thyroid gland helps govern your body’s metabolism, how it uses energy. That affects every part of your body, because of course all parts of ourselves need adequate amounts of energy. T4 affects your breathing, weight, mood, heart rate and digestion.
Normal Ranges of T4 FREE
0.90 to 1.7 nanograms per deciliter (ng/dL) OR:
10.3 to 24.5 picomoles per liter (pmol/L)
Having too little thyroid hormone, hypothyroidism, is associated with symptoms that resemble getting old. Low energy, fatigue, dry skin, constipation, weight gain and depression.
Having too much can result in a strain on your heart, frequent bowel movements, rapid heartbeat and trouble sleeping.
2. Thyroid Function Cascade
TSH
TSH is Thyroid Stimulating Hormone or thyrotropin.
Your pituitary gland produces TSH to tell your thyroid gland how much thyroid hormone it should make. Your pituitary gland bases that decision on the feedback from other tissues. If there’s not enough thyroid hormone, your pituitary gland tells your thyroid to secrete more hormone. If your body’s level of thyroid hormone is already high, your pituitary tells your thyroid to scale back production.
The results of this test indicate whether your thyroid gland is underactive (hypothyroidism) or overactive (hyperthyroidism).
The normal range is: 0.30 to 4.20 mcIUnit/mL.
If you’re outside the normal range, your doctor must evaluate your overall risk. That may require more tests to determine the cause of your thyroid issue.
IV. Vitamin B12
B12 (cobalamin) is an important nutrient made by various microscopic organisms. Because we no longer drink water standing outside, where these bacteria thrive, most people obtain B12 from eating animals (because they’re not fussy about their drinking water).
Because Vitamin B12 is not found in plants, vegans and vegetarians tend to be at higher risk of a B12 deficiency.
We can also obtain it from foods that have had it added to them, from grains to soy milk. There’re also B12 supplements.
Like all the B vitamins, B12 is water soluble. When you’ve got enough, your body simply urinates out the rest. Therefore, having excess B12 is an unusual condition your doctor would want to investigate. That could indicate liver disease.
B12 deficiencies are more common. That can damage your brain and your nervous system. It may cause erectile dysfunction, loss of memory and paranoia.
Conditions such as pernicious anemia may make it more difficult for you to absorb more B12 from the foods you eat.
If you’re vegan or vegetarian, make sure either you eat plenty of foods with added B12 or take regular supplements.
Normal range: 230 to 1,250 pg/mL
V. Blood Lipid Panel
1. Cholesterol
After blood pressure, these are probably the most well-known tests.
Because cholesterol directly indicates risk for our Number One killer – heart disease – in the long run it’s also one of the most important.
So, is having low cholesterol so important because it’s an unhealthy poison?
Just the opposite.
Cholesterol is one of the most important substances comprising your body. It’s also one of the most common, which is why your liver manufactures cholesterol.
Our bodies gave up manufacturing Vitamin C (almost all other animals still do so) some thousands of years ago, even though Vitamin C is an essential nutrient. But our livers still make our own cholesterol.
What is Cholesterol and Why Is It So Important?
Cholesterol is a fat-like substance usually described as “waxy.” It’s in all cells of all animals. It’s a critical component of the structure of our cells. It also helps cells signal each other.
It’s made in all animal cells, but your liver produces the most.
In short, without cholesterol your flesh would drip off your bones and pool on the floor.
So, yes, we need it.
It’s also a precursor to the making of Vitamin D, bile acid and steroid hormones.
Plants make cholesterol only in small amounts. Therefore, plant foods are not practical sources of cholesterol.
Your liver makes all the cholesterol you need. When you ingest additional cholesterol by eating animals, your body has to deal with it. When blood levels of cholesterol are high, your liver stops making it. Thus, cholesterol in your blood influences other aspects of your health.
As a fat-like substance, cholesterol by itself is barely water soluble. Yet, it’s transported from your liver or digestive tract to your cells by your bloodstream.
This is accomplished through lipoproteins. These are complicated particles with fat-soluble, interior-facing surfaces and water-soluble, exterior-facing surfaces.
These lipoproteins come in various types:
* Chylomicrons
* Very-low-density lipoprotein (VLDL)
* Intermediate-density lipoprotein (IDL)
* Low-density lipoprotein (LDL)
* High-density lipoprotein (HDL)
LDL (“bad” cholesterol) lipoproteins are the major carrier of cholesterol in your blood. When cells need more cholesterol, they have LDL receptors to take up more of it. When cells contain enough cholesterol, their receptors for LDL are blocked.
If your body contains more lipoproteins than receptors, the particles that can’t find a receptor to take them in are left out in the cold. They’re the losers in a game of cholesterol musical chairs.
These LDL particles without receptors to attach themselves to become oxidized, and are taken by macrophages. This kind of white blood cell then forms foam cells. These foam cells can become trapped in the lining of your blood vessels, forming plaques. These plaques can then cause heart attacks and strokes, and block blood circulation.
The oxidized LDL particles are why LDL is called “bad” and why it’s so closely associated with risk of cardiovascular disease.
If you had only “just enough” LDL particles, they’d all find a receptor to attach themselves to, and they wouldn’t be “bad.” It’s the excess LDL particles that become oxidized and dangerous.
HDL transports cholesterol back to the liver. While that helps regulate total cholesterol in your body, so it’s “good” to that degree, remember that doesn’t mean you want too-high amounts of HDL either.
The Test Covers Total Cholesterol, HDL & LDL
According to current guidelines, Total Cholesterol is best under 200 mg/dL.
According to Standard Modern Practice
HDL is best at 40 mg/dL and above (while keeping Total Cholesterol under 200 mg/dL).
LDL is best under 100 mg/dL.
Does This LDL Recommendation Need Further Examination?
When it comes to blood pressure, over the past several decades medicine has adopted much stricter standards. As noted above, setting under 120/80 as “normal” means most American adults, especially those older than their 20’s, now have “high” blood pressure. By the numbers, it’s not “normal.”
But, is LDL under 100 mg/dL optimal, or simply “common.”
Remember: in these modern United States, it’s just plain “normal” to drop dead from a heart attack.
What if you’d prefer not to die from a heart attack? What are the “optimal” levels of cholesterol for you? That is, what is the level of LDL which is so low, you do NOT form atherosclerotic plaque?
In a study published in the Journal of American College Cardiology in 2017, researchers compared the LDL test results of nearly 1800 patients and the amounts of their atherosclerosis.
Out of nearly 1800 participants, only two had NO evidence of atherosclerosis. Their LDL scores fell between 50 and 60. Statistically, that’s low. But, remember, they were the only ones with no risk of atherosclerosis.
9 participants had scores between 60 and 70. They had small amounts of atherosclerosis.
The trend continued. The higher the LDL score, the greater the amounts of atherosclerosis. Except for the two people who had LDL under 60, all the participants with “normal” scores below 100 had atherosclerosis.
Conclusion
If your LDL score is below 100 mg/dL, your doctor will probably give you a gold star. But to reduce atherosclerosis risk as much as possible, below 70 is better. Some experts recommend below 50 if you wish to eliminate all risk of cardiovascular disease.
2. Total Cholesterol
This is the sum of your HDL, your LDL and 20% of your triglycerides.
Although the current recommendation for total cholesterol is under 200, resarch suggests it should be under 150.
The largest single medical study in history is the Framington Heart Study. In 34 years, those researchers never found anyone having coronary artery disease with a total cholesterol level under 150.
Therefore, as near as we know now – other risk factors may hurt or help you – you want your total cholesterol below 150.
3. HDL Cholesterol
The recommendations are:
Men:
Under 40 mg/dL – too low
Over 60 mg/dL – good
Women:
Under 50 mg/dL – too low
Over 60 mg/dL – good
These ranges seem to make sense in context.
You do want your HDL to exceed 60. Even if it’s just 60, if your LDL is 50, that’s a total of 110 – which allows plenty of room to add 20% of your triclycerides and still come in under 150.
4. Non-HDL Cholesterol
This marker is relatively new. You may or may not see it the next time you get your blood lipid panel done. However, it is rising in popularity, so you will probably see it eventually.
1. Take your total cholesterol
2. Subtract your HDL
3. The remainder is non-HDL cholesterol
It’s your total “bad” cholesterol. It’s really your LDL plus the other types of non-HDL cholesterol.
That includes very-low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL). These lipoproteins do transport triglycerides through the blood. Eventually, they do become LDL.
There’s no set range. Instead, you want non-HDL cholesterol to be no more than 30 points above your target LDL.
Therefore, if your target LDL is below 100, you want to see non-HDL cholesterol under 130 milligrams per deciliter. 130 mg/dL.
If your target LDL is 70, you want non-HDL cholesterol no more than 100.
If it’s higher than 30 mg/dL above your target LDL, your doctor may need to evaluate how to lower your risk.
5. Ratio of Cholesterol to HDL
It’s total cholesterol to HDL.
Divide Total Cholesterol by HDL.
In general, because HDL is “good,” the lower the figure, the better. It indicates you have the HDL to counter the bad cholesterol.
The desired ratio is 5. 3.5 is even better.
Example: Your Total Cholesterol is 200. Your HDL is 40.
Your ratio is 200 / 40 = 5.
Again – your doctor must evaluate your total risk based on this and the other numbers.
6. Triglycerides
Triglycerides are a form of fat in your blood.
We clearly need some fat. Your cells burn these fats for energy. But too much is a problem.
If you have more triglycerides than you need, your body stores them. That is, of course – as fat. Weight gain. Unsightly bulges.
But there are other issues connected with high triglycerides. They’re a risk factor for heart disease, peripheral arterial disease, metabolic syndrome and stroke.
Very high levels also increase risk for pancreatitis.
Range of Triglyceride Test Results for Adults
1. Under 150 mg/dL – healthy
2. 150 to 199 mg/dL – borderline high
3. 200 to 499 mg/dL – high
4. Over 500 – very high
There’s no established “too low” for this test.
But if you’re below 50, that probably indicates some underlying medical condition.
In any case, too low is quite rare.
VI. Vitamin D
The 25-hydroxyvitamin D test. Or 25(OH)D. Or calciferol.
Also called the “Sunshine Vitamin,” Vitamin D has grown a lot in recognition in the past several decades.
It was originally thought to mainly affect bone health. Doctors believed high amounts were harmful – which is absolutely true – but they greatly underestimated how high too high was. I can remember when the highest Vitamin D supplement you could buy legally in the U.S. was only 400 IU per capsule.
It’s still closely associated with calcium absorption and related bone health. Symptoms of low Vitamin D include fatigue, back pain, frequent illnesses, hair loss and slow wound healing.
In short, a Vitamin D deficiency looks and feels much like getting older.
Low levels of Vitamin D may also be associated with many other medical problems, from cancer and heart disease to multiple sclerosis and Type II diabetes.
These topics are debated. Some say Vitamin D is useful only for calcium absorption and bone health.
However, my doctor places enough importance on it to test me for it every year, and so yours may too.
The suggested range of Vitamin D test results is:
30 – 80 nanograms per milliliter ng/mL
Below 30, and you may be at risk for various problems, though not everybody under 30 has clinically recognized symptoms.
The Food and Nutrition Board at the National Academies of Sciences, Engineering, and Medicine (FNB), however, says 20 ng/ml is sufficient for most people.
The FNB also recommends not going over 50 – 60 ng/mL.
Vitamin D increases the absorption of calcium in your digestive tract. Excess Vitamin D can result in: hypercalcemia, hypercalciuria, renal failure, cardiac arrhythmias, calcification of soft tissues and death.
Getting Vitamin D from sunlight exposure regulates itself. When your body has enough Vitamin D, it stops turning sunlight into more.
So Vitamin D in toxic amounts comes only from supplements.
The FNB recommends adults take up to 4000 IU per day, but no more.
VII. HbA1c
Hemoglobin A1c
This test is amazing because it’s not measuring how much of something is in your blood right now – but over the past two to three months.
Granted, many of these test results don’t change much, but none of them indicate where your ferritin (for example) was last month.
The A1c reflects how much sugar has been in your blood over the past three months. Obviously, it’s an average. Like everything else, your sugar goes up and down throughout every day.
You’d need a blood monitor to track it continuously. The A1c test can’t do that, but its result does sum up your blood sugar for the last three months.
Doctors use it as an indicator of diabetes risk.
The sugar/glucose comes originally from what you’ve just eaten. The hormone insulin tells your cells to take the glucose out of your blood, so they can use it for energy.
But if you don’t make enough insulin, or your cells don’t take in enough sugar, that’s an indicator of Type II diabetes.
This works because glucose sticks to the hemoglobin – a protein in your red blood cells – for as long as the red blood cell remains alive.
Red blood cells live around two to three months. Therefore, the amount of glucose now sticking to your hemoglobin indicates how much has been in your blood for the lifetime of the current red blood cells.
Range of Results
1. A1c below 5.7% – normal/healthy
2. A1c from 5.8% to 6.4% – prediabetes
3. A1c over 6.4% – diabetes
VIII. CBC W/ Auto Differential
Complete Blood Count With Automatic Differential
Obviously, healthy blood is critical to our overall health.
These tests measure blood components such as white blood cells, red blood cells, platelets, hemoglobin and hemocrit.
Once again, balance is importance. Too little of a critical component indicates some kind of blood dysfunction, such as anemia, heart disease, dehydration or you’re deficient in iron. Too few white blood cells could be caused by cancer, bone marrow disorders or autoimmune disorders.
But having too much could be a sign of some other type of problem.
For instance, having too many white blood cells could be caused by an infection that needs to be treated.
1. WBC
White Blood Cells
These are critical components of your immune system. They protect you against bacterial, viral and parasitic infections, and cancer.
Normal range: 3.80 to 9.90 K/cumm
2. Hct
Hemacrit
This is the percentage of red cells in your blood.
Normal range: 38.9% to 50.3%
3. MPV
Mean Platelet Volume
This measures the average size of your platelets.
Normal range: 9.1 to 12.3 fL
4. MCV
Mean corpuscular volume
This measures the amount, size and strength of your red blood cells.
Normal range: 81.3 to 96.4 fL
5. MCHC
Mean Corpuscular Hemoglobin Concentration
This measures the average amount of hemoglobin in your red blood cells.
Low MCHC can mean you have anemia, making you tired and weak.
Normal range: 32.3 to 35.7 g/dL
6. RDW SD
Red Cell Distribution Width Standard Deviation
This indicates the variability in the size of your red blood cells.
If this is too low, it could indicate sickle cell anemia or liver disease or other conditions.
If too high, it could indicate iron deficiency anemia, Vitamin B12 deficiency or a bone marrow disorder.
Normal range: 35.7 to 48.1 fL
7. Hgb
This is the amount of hemoglobin in your blood.
Hemoglobin is the protein within red blood cells that transports oxygen to all your cells.
Low hemoglobin is a common indicator of anemia. Obviously, your cells can’t function at full potential if they’re chronically short of oxygen.
High hemoglobin could indicate other health issues.
Normal range: 13.0 to 17.5 g/dL
8. Plt
Platelets
Platelets are the blood component that enable clotting.
Low or high test results could indicate anemia, blood cancer, bleeding disorders or bone marrow problems.
Normal range: 150 to 400 K/cumm
9. RBC
Red Blood Cells
They’re the main component of blood – obviously, what makes it red.
Normal range: 4.30 to 5.80 M/cumm
10. MCH
Mean Corpuscular Hemoglobin
It’s the average amount of hemoglobin in your red blood cells.
Both high and low amounts may indicate various types of anemia.
Normal range: 27.1 to 33.3 pg
11. RDW CV
Red cell Distribution Width
Calculates how much variation there is in the width of your red blood cells.
Results outside the normal range may indicate iron deficiency anemia, Vitamin B12 deficiency or other problems.
Normal range: 11.1 to 14.9 %
12. NRBC abs
Nucleated Red Blood Cells
These are immature cells that normally should be not in the blood of adults.
This test measures the presence of NRBCs in your blood.
The figure should be very small.
If this figure is too high, it may indicate your bone marrow is under stress. That points to possible anemia, leukemia or other blood disorders.
Normal range: 0.00 to 0.01 K/cumm
IX. Comprehensive Metabolic Panel
This set of tests provides your doctor with an overview of your metabolism and chemical balance. That includes electrolytes, markers of liver and kidney function, and glucose.
1. Sodium
This is an electrolyte, so it affects the fluid balance within our bodies.
Overconsumption of sodium is a prime cause of high blood pressure. It should be in balance with potassium.
Food processors add sodium to just about every packaged food to help preserve it and because we all crave the taste, so people eat (and buy) more foods that contain sodium.
Normal range: 135 to 145 mmol/L
2. Potassium, pl
This is the electrolyte that our bodies were designed to use to balance the sodium we consume.
In a sense, much high blood pressure is caused not just by too much sodium, but by consuming too little potassium.
Normal range: 3.3 to 4.9 mmol/L
3. Chloride
This is another common electrolyte, so it helps maintain fluid balance, and to maintain the correct pH (acid/alkaline) balance in your blood.
Obviously, a lot of people consume it along with sodium – sodium chloride is common table salt.
If too high or too low it may indicate high blood pressure, kidney disease, liver problems and heart failure.
Normal range: 97 to 110 mmol/L
4. CO2
Carbon dioxide
This gas is produced by your cells as a waste product. Your blood transports it to your lungs, where you exhale it.
It’s another indicator of your vital acid-base (pH) balance. Your body goes to great lengths to maintain a healthy pH balance. There’s not a lot of wiggle room.
Your blood should have a pH that’s slightly alkaline – from 7.35 to 7.45.
When CO2 levels are too high, your blood is too acidic, and you run the risk of acidosis.
When CO2 levels are too low, your blood is too alkaline, and you run the risk of alkalosis.
This may indicate kidney disease, respiratory disorders such as Chronic Obstructive Pulmonary Disorder (COPD) or metabolic disorders.
Normal range: 22 to 32 mmol/L
5. Anion gap
This test measures the distance between positively charged ions (cations) and negatively charged ions (anions).
The calculation is: Anion Gap = [Sodium (Na+) + Potassium (K+)] – [Chloride (Cl-) + Bicarbonate (HCO3-)]
A test result in the normal range indicates a balance of electrolytes in your blood.
If the gap is too large, you may have metabolic acidosis from diabetes, kidney failure or poison.
Normal range: 2 to 15 mmol/L
6. BUN
Blood Urea Nitrogen
This is a waste product from your kidneys breaking down protein.
Too little may indicate a decline in kidney function due to injury or chronic kidney disease.
It can also be caused by a high protein diet, by dehydration, liver disease or heart failure.
Normal range: 6 to 25 mg/dL
7. Creatinine
If you’re taking the popular supplement creatine, you may confuse the two.
They are related.
Creatinine itself is a waste product from your kidneys filtering muscle tissue. It’s normal.
However, if it’s too high, that may indicate kidney problems.
When you take creatine, your body converts it to creatinine. When creatine was first studied, this caused concern that taking it as a supplement was damaging kidneys. More recent studies show the elevated creatinine in people who supplement with creatine comes from that conversion, without affecting kidney function.
My doctor told me creatine does damage the kidneys of some of her patients, but not others.
In any case, if you do take creatine as a supplement, and your doctor orders this particular, make sure you alert them.
Normal range: 0.80 to 1.30 mg/dL
8. Glucose
This is the form of sugar your body’s cells use for energy.
You need adequate amounts, or you’re starving your cells.
But at high amounts, glucose damages your tissues – causing the side effects of diabetes such as retina damage and pain in your nerves.
So this test helps measure how well your body keeps blood glucose under control.
Normal range: 70 to 99 mg/dL
Glucose from 100 mg/dl to 125 mg/dl indicates prediabetes.
Glucose of 126 mg/dl and over indicates diabetes.
9. Calcium
This is a critical mineral we need for our bones, our teeth and many vital biochemical functions throughout our bodies.
So you also need some in your blood to maintain proper functioning of your heart and muscles.
Unfortunately, sometimes it gets attached to plaque in the linings of your arteries, where it’s dangerous.
Abnormal blood calcium may indicate osteoporosis, parathyroid gland dysfunction, certain types of cancer, kidney stones and bone disease.
Normal range: 8.5 to 10.3 mg/dL
10. Bilirubin, total
This is a yellow pigment produced by the breakdown of red blood cells. It’s removed from your body by your liver.
High levels of bilirubin in your blood may indicate liver problems. That could be liver disease or damage or obstruction of the bile duct.
Bilirubin is the reason why people with hepatitis or other liver problems get jaundice – yellowish skin.
Normal range: 0.1 to 1.2 mg/dL
11. Albumin
Your liver produces this protein to maintain blood volume, transport nutrients and prevent the leakage of fluid from your blood vessels.
Low levels may indicate kidney or liver disease, inflammation or malnutrition.
Normal range: 3.5 to 5.0 g/dL
12. Alk phos
Alkaline Phosphatase or ALP
This is an enzyme found in your entire body.
Generally, enzymes are worker proteins that perform various biochemical reactions and functions. But the two main sources of ALP are your bones and your liver.
Although it’s been studied for decades, researchers still aren’t sure exactly what ALP does.
However, we do know abnormal levels of ALP may indicate health problems, especially in your liver.
Normal range: 40 to 130 Units/L
13. ALT
Alanine Aminotransferase
This is another marker for liver function. Abnormal results may indicate liver disease or damage.
Normal range: 7 to 55 Units/L
14. AST
Aspartate Aminotransferase
This is an enzyme found largely in your liver, but also in your kidneys, heart and muscles.
Damage to these tissues releases AST into your blood. Therefore, high levels of AST may indicate underlying damage, especially to your liver.
Normal range: 10 to 50 Units/L
X. Differential Auto
Complete Blood Count (CBC) with differential
These tests measure various kinds of white blood cells.
White cells make up about 1% of the cells in your blood.
Having too few may indicate a dangerously inadequate immune system.
Having too many may indicate an infection, inflammation or other medical issue.
1. Neutrophil abs
Absolute neutrophil count
Neutrophils are a common type of white blood cell.
Normal range: 1.50 to 6.50 K/cumm
2. Imm gran abs
Absolute immature granulocytes
Granulocytes are the most common type of white blood cell.
Having too many immature granulocytes in your blood may indicate a problem with your bone marrow. Or it could mean an early response to an infection.
Normal range: 0.00 to 0.10 K/cumm
3. Lymphocyte abs
Absolute lymphoctes
Lymphocytes make up about 40% of your blood volume.
Low lymphocytes may indicate immune system-related problems, including cancer.
High lymphocytes may indicate an infection, leukemia or inflammation.
Normal range: 0.80 to 3.30 K/cumm
4. Monocyte abs
Absolute monocytes
A low count is often caused by suppression of your immune system, such as by chemotherapy or an HIV infection.
A high count may indicate an infection, an autoimmune disorder or blood cancer.
Normal range: 0.20 to 0.80 K/cumm
5. Eosinophil abs
Absolute eosinophils
A low count may be caused by use of steroids or too much stress.
A high count may be caused by parasites, allergies or some medications.
Normal range: 0.00 to 0.50 K/cumm
6. Basophil abs
Absolute basophils
Basophils are important to your immune system. They’re also involved in allergies and inflammation.
A low basophil count is rare, and may be caused by infections, thyroid problems, lupus and use of steroids.
A high basophil count may be caused by infections, including Covid-19, allergies, chronic inflammation, leukemia and hyperthyroidism.
Normal range: 0.00 to 0.10 K/cumm
XI. eGFR
Estimated Glomerular Filtration Rate
Your kidneys make urine by removing waste. The glomerular filtration rate is simply the speed at which they function.
The actual rate is difficult to measure. It’s complicated and impractical for everybody – doctors and patients.
Therefore, doctors use an estimate based on a calculation using creatinine and cystatin C. Cystatin C is a protein that slows the breakdown of other proteins.
(Creatinine itself is covered in the Comprehensive Metabolic Panel section. Supplementing with creatine definitely could affect this marker, so if you are taking creatine as a supplement, make sure you tell your doctor so they can take that into account.)
It’s estimated 37 million American adults have chronic kidney disease, but 90% of them don’t know it. Early awareness of the condition helps them protect their kidneys.
If your kidneys filter waste too slowly, that’s an indication of kidney disease.
Normal value: >=60 mL/min/1.73 m2
Range Results
1. Above 90 – normal/healthy
2. From 60 to 89 – possible early-stage kidney disease
3. From 15 to 59 – possible kidney disease
4. Below 15 – possible kidney failure
XII. CRP
C-Reactive Protein
It measures the amount of c-reactive protein in your blood.
That’s a protein your liver manufactures in response to inflammation.
This is the test often suggested when discussing chronic inflammation.
It is not a routine blood test given during annual checkups.
High amounts could indicate infection, chronic inflammation, inflammatory bowel disease or autoimmune disorders such as lupus or rheumatoid arthritis.
You could also have a too-high CRP test result if you’re a smoker or you’re exposed to environmental toxins.
The normal/health result is:
Below 0.8-1.0 milligrams per deciliter (mg/dL)
Blood Tests for Men Only
PSA
Prostate Specific Antigen.
The prostate is a small organ usually compared to a walnut, that has your urether go right through it, on its way from your bladder to the tip of your penis.
Your prostate’s job is to add fluid to your semen for when you ejaculate.
Your prostate makes and releases PSA into the semen to keep it in liquid form, so sperm can swim to the egg cell once it’s been ejaculated into a woman.
It’s normal for some PSA to go into your blood instead of your semen. Therefore, it’s not uncommon for this test to find PSA in your blood.
In many men, the prostate swells with age. If the growth in harmless, it’s called Benign Prostatic Hyperplasia (BPH). At best, it’s irritating. It can lead older men to have problems urinating, but also to need urination much more often, especially at night.
A high PSA reading may also result from a urinary tract infection.
However, a PSA reading that’s elevated may also indicate prostate cancer. That’s why older men need the test.
Because PSA plays no role in your blood, it’s okay if the test result is zero. For this test, there’s no “too low” result.
The “too high” varies by age.
Acceptable Ranges by Age
0-49 years 0 nanograms per milliliter (ng/mL)
50-59 years 0-3.90 ng/mL
60-69 years Male 0-5.40 ng/mL
70-on years 0-6.20
Testosterone
This of course is the hormone generally associated with masculinity. Although women have some too, men should have more.
Testosterone levels in men peak in their 20’s. After age 40, they decline 1% to 2% per year.
Because this age-related decline is normal, doctors don’t routinely measure testosterone levels in men during routine checkups.
If you feel you are low in this hormone, discuss it with your doctor.
For Women Only
When it comes to blood work, women mainly get the same blood tests as men – minus the PSA.
Women do need other forms of screenings, such as mammograms and PAP smears.
Because, like testosterone, estrogen falls with age, a blood test for that hormone is not part of a routine checkup.
If you believe that could help you, discuss it with your doctor.
References:
https://my.clevelandclinic.org/health/diagnostics/17820-ferritin-test
https://www.redcrossblood.org/local-homepage/news/article/iron-in-blood.html
https://medlineplus.gov/ency/article/003517.htm
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