10 essential blood tests · 2017-03-23 · 10 essential blood tests –part 2 dr. dicken weatherby...

10EssentialBloodTests– Part2Dr.DickenWeatherby

©Weatherby&Associates,LLChttp://BloodChemSoftware.com 1

10EssentialBloodTestsPART2

TheBloodChemistryWebinarsWithDR.DICKENWEATHERBYCreatoroftheBloodChemistrySoftware

Presents

HeartDisease,Inflammation,&EssentialBloodTests#2to#4:

Fibrinogen,C-Reactiveprotein,andHomocysteine,



EssentialTest#2Fibrinogen



Fibrinogen- Whyisitimportant?

1.Levelsincreasewithtissueinflammationortissuedestruction.

2.Itisvitalpartofthecoagulationprocess3.Higherlevels tipinthefavorofclotformation4.Thiscanhappenatthesiteofrupturedcoronaryplaque

5.CanleadtoMIifdislodged6.↑fibrinogencanalsoleadtogrowthofplaqueformation

Fibrinogen- OptimalRange

200– 300mg/dLor

5.9– 8.8µmol/L



ElevatedLevelsofFibrinogen

1. CardiovascularDisease:– M.I.– CoronaryHeartDisease

2. Cancer3. Medications

Fibrinogen:Summary• Fibrinogenlevelsshouldbecheckedin

patientsatriskforheartdisease,stroke,andwithcancer,especiallycoloncancer

• Tryandreducepatients’fibrinogenlevelstoaround200– 300mg/dlor5.9– 8.8µmol/L

• Thismaybedifficultbutanyreductioninfibrinogenmaycorrelatewithareducedriskofheartattack,stroke,ancancer



EssentialTest#3C-Reactiveprotein

C-ReactiveProteinOptimalRanges

Men:<0.55mg/L

Women<1.5mg/L



WhatcausesincreasedCRP?

• Diet• Peridontal Disease• Smoking• HighBloodPresure• SyntheticFemaleHormones

ElevatedCRPLevels• Increasedriskofcardiovasculareventsheartdiseaseandstroke

• IncreasedAlzheimer’srisk• Depression• Diabetes



EssentialTest#4Homocysteine

CausesofElevatedHomocysteine

• B-vitamin deficiency• Genetic factors• Remethylation deficits• increasing age• kidney impairment



Homocysteine overload increases the risk of disease

in healthy people and magnifies adverse effects in

those with pre-existing conditions.

Homocysteine-OptimalRanges

Men:<7.2μmol/LWomen<7.2μmol/L



DiseasesAssociatedwithElevatedHomocysteine

• Cardiovascular disease: Heart attacks and atherosclerosis

• Stroke• Colon cancer• Cervical cancer• Depression• Alzheimer’s disease

Homocysteine- Summary• ElevatedHomocysteineassociatedwithagrowinglistofdiseases

• Testinallyouradultpatients• Keeplevelsbelow7.2• ModulateelevatedlevelswithB6,B12,folateandtrimethylclycine



EssentialTest#5:ThyroidStimulatingHormone

(TSH)

ThyroidOptimalRangesOptimal Range

TSH 1.3 – 3.0 mIU/L

Total T4 6.0 – 11.9 µg/dL77 – 154 nmol/L

Total T3 90 – 168 ng/dl1.4 – 2.6 nmol/L

Free T3 3.0 – 3.5 ng/dl300 – 350 pg/dl

Free T4 1.0 – 1.5 ng/dL12.9 – 19.3 pmol/L

Reverse T3 10 – 25 ng/dl0.15 – 0.27 ng/ml



ThyroidDysfunction• Hypothyroidism

– Primary– Secondary– T4underconversion(lowT3Syndrome)

• Iodineinsufficiency• Seleniuminsufficiency• Hyperthyroidism

PrimaryHypothyroidism-Pattern

• TSH>2.0• NormalordecreasedtotalT4level(<6.0

mcg/dL)• NormalordecreasedT-3(<90ng/dl)• NormalordecreasedfreeT4(<1.0ng/dl),• NormalordecreasedfreeT3(<3.0ng/dlor

300pg/dl)• Thyroidantibodiesoftenelevated



SecondaryHypothyroidism-Pattern

• AdecreasedTSH(<1.30)• NormalordecreasedtotalT4level(<6.0mcg/dL)

• NormalordecreasedT-3(<90ng/dl)• NormalordecreasedfreeT4(<1.0ng/dl),

• NormalordecreasedfreeT3(<3.0ng/dlor300pg/dl)

• Symptomsofhypothyroidism

T4ConversionHypothyroidismLowT3SyndromePattern

• NormalTSH• LowtotalT3(<90)• LowfreeT3(<3.00),• NormaltotalT4• NormalfreeT4• IncreasedreverseT3(>25)



ThyroidAntibodies• Anti-thyroglobulin antibody(Tg-Ab)

• ThyroidReceptorantibodies(TR-Ab andnewerTSI)

• Thyroidperoxidase antibody(TPO–Ab)

EssentialTest#6HemoglobinA1C



HemoglobinA1C-Background

• Measuresglycosolation inRBCs• Thelongerbloodglucoseremainshighthegreatertheglycosolation

• HGBA1Creflectsaverageglucosecontroloverpast120days

HemoglobinA1COptimalRange

IdealtokeepHemoglobinA1Cbetween4.5– 5.5%



HemoglobinA1CWhyisitimportant?

• Monitoringlong-termglucosecontrolindiabeticsandpre-diabetics

• EvaluatingCardiacrisk

EssentialTest#7VitaminD



VitaminD- Role• Skeletalsystem• Glucosemetabolism• Cardiovascularsystem• Immunesystem• Adrenalhormonesynthesis

VitaminDReferenceRanges

• AssessVitaminDbychecking25(OH)vitaminD• Deficientlevels: <20ng/ml(<50nmol/L)• Insufficientlevels: 20– 40ng/ml(50– 100nmol/L)• Optimallevels: 40– 65ng/ml(100– 160nmol/L)• Excesslevels: >100ng/ml(>250nmol/L)



EssentialTests#8- #10HormoneTesting

DHEA,Estradiol,andTestosterone

EssentialBloodtest#8

DHEA-S



DHEAReferenceRanges• Normalreferencerange:

– Men:280– 640μg/dL– Women:65– 380μg/dL

• Optimalreferencerange:– Men:400– 500μg/dL– Women:350– 430μg/dL

LowDHEALevels• Mooddisorders• Sexualdysfunction• Coronaryarterydisease• Osteoporosis• Increasedinsulinresistance




Estradiol

Estradiol- ReferenceRanges

• Normalreferencerange:– Men:<54pg/ml– Women:0– 528pg/ml

• Optimalreferencerange:– Men:10– 30pg/mL– Women352– 528pg/mL



EstradiolinWomen• Lowestradiolincreasesriskofosteoporosis

andbonefracture• Estradiolmayimprovequalityoflifein

menopausalwomen• Migraineheadaches• Increasedlevelsofestradiolinwoman

suggestanincreasedriskofbreastorendometrialcancer

EstradiolandMen• low levels of estradiol in men

affect bone density and risk of fractures if too low

• Low estradiol increase risk of osteoporosis

• High estradiol and coronary artery disease




FreeTestosterone

FreeTestosterone- ReferenceRanges

• Normalreferencerange:– Men:6.6– 26.5pg/ml– Women:0– 2.2pg/ml

• Optimalreferencerange:– Men:15– 26.5pg/mL– Women:1.4– 2.2pg/mL



LowTestosteroneLevelsinMen

• Diminishedlibido• Erectiledysfunction• Lossofmuscletone• Increasedabdominalfat• Lowbonedensity• Metabolicsyndrome• Diabetes• Heartdisease

Lowtestosteroneasamajorcardiacriskfactor

• Age,HDLlevels,andfreetestosterone

• Increasedriskofstroke• Heartfailure• Increasedglycation



ImportanceoftestosteroneinWomen

• Musclestrength• Bonemass• Sexualfunction• Mood• Bodycomposition

SUMMARY



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10 essential blood tests · 2017-03-23 · 10 essential blood tests –part 2 dr. dicken weatherby...

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