UNDERSTANDING BLOODWORK…A LAYMAN’S GUIDE

By Leigh Penman
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Updated: March 4, 2009

By Leigh Penman –

I am sure you have all, at one time or another, given your arm to the doctor and submitted to the drawing of blood in order to gain an insight into your overall health. Analyzing the various components of your blood can give a very accurate picture of your state of health and can also greatly assist the process of determining and correcting the cause of any malaise.

However, if you have been confronted with a copy of your evaluation you may be somewhat confused by the data set out before you. In this article I hope to simplify the information presented in a standard blood panel and, in so doing, assist you in understanding each reading and what it means in terms of your well being. This way, the next time you receive a copy of your blood work you will have a better idea of what each section is about.

Let’s start with the general blood count:

WBC (White Blood Cell)

White blood cells are also referred to as leucocytes. Any deviations from the given reference range can be indicative of infection and stress on the immune system.

Linked to White Blood Cells are Neutrophils. These are white blood cells that are only in the circulation for a short period of time. Their job is to kill bacteria that can lead to infection. There are several factors that can lead to their elevation, including bacterial infections, inflammatory or metabolic disorders and even stress can cause an increase in total Neutrophil count. If, on the other hand, the level falls on the low side of the reference range provided on your document, this could indicate the presence of a viral infection, a bacterial infection or perhaps a diet that is lacking in essential nutrients.

RBC (Red Blood Cell)

Also known as erythrocytes, the primary function of red blood cells is to transport oxygen (via their hemoglobin content) to the various tissues of the body. Unlike Neutrophils, red blood cells have a long life span – surviving in the peripheral blood circulation for approximately 120 days. When a decrease in these cells is noted a condition known as anemia can result. If the level of RBC falls on the high side of the given reference range there could be a danger of high blood pressure or stroke. Athletes who use androgens often experience elevated RBC’s and this can create significant health risks. Should your RBC be naturally on the high side then it is wise to consider modifying your diet and perhaps even donating blood to bring it back down to acceptable levels.

HEMOGLOBIN

Molecules of hemoglobin are found within each red blood cell. Hemoglobin serves as a carrier for oxygen and carbon dioxide transportation. If there is an increase in the level of hemoglobin present it can be an indicator of congenital heart disease, congestive heart failure or dehydration. Patients with severe burns may also exhibit high hemoglobin levels.

A low hemoglobin count can be an indication of the presence of anemia, kidney disease, severe hemorrhage or sickle cell anemia. If the level is significantly low the doctor may decide to carry out additional tests to determine the cause.

Linked to RBC count is Hematocrit. This is a measure of the total blood volume that is made up of red blood cells. An increase in hematocrit may be an indication of congenital heart disease, dehydration, diarrhea, burns etc. A decrease would indicate anemia, hyperthyroidism, cirrhosis, hemorrhage, leukemia, rheumatoid arthritis, pregnancy or malnutrition. Once again, a significant deviation from the reference range provided would mean that further tests would have to be carried out to determine the true cause.

MCV (Mean Corpuscular Volume), MCH (Mean Corpuscular Hemoglobin), MCHC (Mean Corpuscular Hemoglobin Concentration.

The MCV is the size and volume of the average red blood cell and is one of the three red blood cell indices, which are used in order to discover whether or not abnormalities exist. An increase in MCV can be caused when the red blood cells are abnormally small and this could indicate a deficiency of vitamin B12 or folic acid. It could also point to liver disease. On the other hand, a decrease in MCV would indicate that the red blood cells are abnormally large and this is usually a factor observed in iron deficiency anemia.

MCH (Mean Corpuscular Hemoglobin)

The MCH index is yet another measurement used to detect anemia and refers to the weight of hemoglobin present in the average red blood cell.

MCHC (Mean Corpuscular Hemoglobin Concentration)

The MCHC measures the amount of hemoglobin present in each red blood cell compared to its size. When a decrease is noted iron deficiency is usually the cause although it could also indicate toxic levels of lead in the system. On the other hand an increase in this reading is sometimes attributed to the use of androgens.

PLATELET COUNT

Essential when it comes to your body’s ability to form blood clots and stop bleeding, platelets are measured in order to assess the likelihood of specific disorders. A decrease in platelet count can indicate infection, anemia or even leukemia. An increase could be due to the presence of rheumatoid arthritis, iron deficiency anemia or a malignant disorder.

NEUTROPHILS

When an increase in Neutrophil levels is observed the causative factors are usually severe trauma, inflammatory or metabolic disorders, bacterial infections and even stress. If the number of Neutrophils is on the low side it can indicate a viral or bacterial infection. It can also be caused by a poor diet.

BASOPHILS

Unlike Neutrophils, Basophils do not increase in the presence of bacterial or viral infections and if an increase is noted it is usually caused by an allergic response or a parasitic infection.

LYMPHOCYTES AND MONOCYTES

Lymphocytes function to fight off bacterial and viral infections and can be divided into two different types of cells: T Cells and B Cells. T Cells are involved in immune reactions and B cells are involved in antibody production.

Monocytes are similar to Neutrophils in action, however they are produced more rapidly and remain in the system for a longer duration.

BUN (Blood Urea Nitrogen)

BUN is a useful reference point when it comes to evaluating liver and kidney function. When protein is metabolized it produces an end product called urea. Urea is formed in the liver and removed from the bloodstream via the kidneys. If an increase in BUN levels is noted it can point to dehydration, excessive protein consumption, excessive protein catabolism, starvation, renal disease and heart malfunctions. On the other hand a decrease in BUN may indicate over hydration, malnutrition and impaired liver function.

CREATININE

Creatinine is a byproduct of creatine phosphate which is the chemical used during the contraction of skeletal muscle. When you ingest large amounts of beef and other meats containing significant amounts of creatine your creatinine levels will reflect this by displaying an increase. In addition to this, the more muscle mass you carry the higher your creatine levels will be. However, a significant elevation in Creatinine levels can be attributed to a urinary tract obstruction, acute tubular necrosis, reduced renal blood flow and acromegaly. Decreased levels can result from debilitation or a decrease in muscle mass connected with an existing medical condition.

BUN/CREATINE RATIO

When this ratio is high it can indicate dehydration, hypotension, gastrointestinal bleeding and, less frequently, a catabolic state. On the other hand, a low ratio could be caused by a low protein diet, liver disease or malnutrition. However, it is important to note that athletes following a high protein diet will usually display higher ratios and this would therefore not be a cause for concern.

ENDOCRINE FUNCTION-TESTOSTERONE

The Leydig cells in the testicles form about 95% of the circulating testosterone in a man’s body. Women also produce testosterone (though in significantly smaller amounts) and this is secreted by the ovaries and the adrenal glands). If testosterone levels in men are excessively low this is usually addressed by the administration of hormone replacement therapy. The occurrence of low testosterone in women is sometimes witnessed during peri-menopause and post menopause. If this condition (i.e. low testosterone) is significantly reducing a woman’s quality of life (e.g. low libido, fatigue, depression) a small amount of supplementary testosterone may be prescribed. The use of anabolic/androgenic drugs will obviously cause elevated testosterone readings in both sexes.

LUTEINIZING HORMONE (LH)

This is a glycoprotein secreted by the anterior pituitary gland and is responsible for triggering the Leydig cells to produce Testosterone. By measuring LH levels it can be determined whether a low testosterone reading is caused by the testicles not being responsive to LH or whether the fault lies with the pituitary gland not actually secreting enough LH. The hypothalamus could also be responsible as it secretes ‘Luteinizing Hormone Releasing Hormone.

In cases where the testicles are observed as being non responsive to LH, substances such as clomiphene and HCG will offer little assistance. However, if the fault lies with pituitary gland and its failure to secrete enough LH improvement should be observed following drug therapy.

ESTRADIOL

Estradiol is the most potent of the estrogens and elevated levels can lead to water retention, fat gain. Gynecomastia and occasionally prostate enlargement and tumors. Since this is the primary estrogen involved in the suppression of testosterone and elevated level goes hand in hand with a hypogonadic state (low testosterone). Increased estradiol levels can also be indicative of testicular tumor, adrenal tumor, liver disease and hyperthyroidism. Due to its potential to create significant disruption it is important for men to pay attention to estradiol levels.

So there you have it, a look at some of the basic categories covered during a routine blood panel. By understanding these values you can now enter an educated and productive discussion with your physician next time you get your blood work done.

Leigh Penman, in addition to be a staff writer at MuscleSport Mag, has been writing for bodybuilding magazines, websites and nutritional supplement companies since 1985. Whilst residing in the UK, she earned the reputation of being one of the top female writers in bodybuilding-related media. Her credits included being a contributing editor on all the magazines in production as well as filling the shoes of Ladies Editor and Showbiz Editor on two publications (the later being on Arnold’s sanctioned magazine, ‘Bodypower’). During this time she also competed successfully on four occasions (placing in the top four in all contests). Relocating to New York in the late 1990s she focused her writing attention to crystal healing techniques and metaphysics – however, she still maintained a five day workout schedule during this time and gained her personal training certificate. Having also studied pharmacology in relation to sports performance, her writing began taking her in that direction until the present day which sees her embarking on a return to the magazine world, as well as extending her web-related work in the bodybuilding and fitness field. Leigh has been working out for close to thirty years so she is clearly a writer who ‘walks her talk.’ She can be contacted personally at zeal2heal@yahoo.com.