At Bloomington Primary Care, we have integrated a Patient Portal to help you access your personal health record. Once you are enrolled, you will be able to access your health history, medication lists, view upcoming appointments, immunizations and health history.
Another feature of the Patient Portal is that you can access your lab results at your convenience. Because lab results can be difficult to read and interpret, we want to make sure that you have a little bit of background about normal values versus abnormal. At Bloomington Primary Care, we review all lab results and make comments before results are posted on an as needed basis. In all cases, if the labs are abnormal in a meaningful way, we should be contacting you for follow-up with a nurse, another test, or another appointment.
If, as you review your test results, you note that a lab result is significantly abnormal and that we have not made a comment or contacted you, please call our office to schedule an appointment. We encourage you to be an advocate for your health, particularly if there a question that we have not addressed.
Please Note: This information is included as a reference to help you better understand your lab results and is not be used for diagnosis.
Cholesterol is a measure of cardiac risk and stroke risk. A lipid panel measures total cholesterol and provides readings which are broken down into 3 subsections: Triglycerides, HDL and LDL.
Triglycerides are most diet and weight sensitive. They are affected easily by lifestyle changes. Ideally, this reading should be less than 150, although if the remainder of the cholesterol panel is within normal limits, we will tolerate upwards of 250-300. For the most part, if triglycerides are the only part of your cholesterol panel reading as 'abnormal', it is best to lose weight and modify your diet, including less saturated fat and less simple sugars. Please refer to our Patient Education section, specifically the TLC (Therapeutic Lifestyle Changes) diet handout from the National Institutes of Health or our Quick Tips for Cholesterol handout. Both of these are available as printable PDF files.
HDL is your 'good cholesterol.' Ideally, the reading should be over 40 and is particularly helpful when it is greater than 60. Research indicates that high HDL is extremely protective; and if your HDL level is greater than 60, we tolerate far worse LDL or triglyceride levels. For the most part, HDL is responsive to aerobic activity and ideal weight. We do not have medicines that increase the HDL reading very easily.
LDL is your 'bad cholesterol.' Our goals depend on how many cardiac risk factors you have. If you are diabetic or have had a heart attack, we like the LDL level to be less than 100. If you have 2 cardiac risk factors (such as diabetes, hypertension, family history, a low HDL and smoking), we like your LDL to be less than 130. If you have 0-2 cardiac risk factors, we like your LDL level to be less than 160, but we may not necessarily initiate medications to 190 unless you cannot lower it. Again, to decrease your LDL level to a healthier range, please refer to the TLC (therapeutic lifestyle changes) diet on our Patient Education page.
General Health Panel:
A measure of general health, this panel includes the Complete Blood Count (CBC), Comprehensive Metabolic Panel (CMP), and Thyroid tests.
Complete Blood Count (CBC):
White blood cells: These are infection fighting cells. Mild fluctuations may represent minor illness at the time of blood draw. Marked fluctuations can represent immune diseases. White blood cells are broken into six sub-sections: bands, neutrophils, lymphocytes, monocytes, eosinophils and basophils. (See the breakdown below for more information about these components.)
Red blood cells: Sign of anemia. If you are significantly out of this range, we may need to talk with you.
Hemoglobin: A key indicator for anemia. Ranges depend on age. If you are significantly out of this range, we may need to talk with you.
Hematocrit: Another way of looking at anemia, much like your hemoglobin. If you are significantly out of this range, we may need to talk with you.
MCV: This looks at the size of your red blood cells. A small number may imply iron anemia or genetic disorder such as alpha-thalassemia. We may check Iron studies called Ferritin to see if you are low. A large number may indicate a B-12 deficiency, medication-induced phenomenon, or a need for further workup.
MCH: Much like MCV above.
Platelets: These are clotting factors. We tolerate a broad range in this. If your numbers are less than 100, we may need to work it up. If your numbers are elevated, this could represent ongoing inflammation within the body. We usually are not concerned unless it is greater than 600.
Bands: These are part of your white blood cells. They aggressively fight bacterial infection. If up past 10, we may need to look for infection or re-check.
Neutrophils: These are part of your white blood cells that fight bacteria much like Bands.
Lymphocytes: These are part of your white blood cells that fight virus.
Monocytes: These are part of your white blood cells that fight virus and less likely, parasites.
Eosinophils: This is part of your white blood cells that are evolved in allergic reactions and rarely parasites.
Basophils: This is part of your white blood cells involving allergic reactions.
CMP (Comprehensive Metabolic Panel):
Broadly, this is a test of organ function including the kidneys, liver, and electrolyte levels.
Glucose: This is primarily looking for diabetes. We like your blood glucose level to be less than 100 when fasting. Readings of 100-125 indicate what we call 'pre-diabetes' or 'glucose intolerance.' This does not necessarily indicate diabetes, but we may check another test called a hemoglobin A1C for confirmation. This level puts you at great risk for becoming a true diabetic and we would encourage the reduction of simple sugars and processed white flour as well as appropriate weight loss. If this number is greater than 125, it is likely you are diabetic; we will get an additional hemoglobin A1C test and will likely schedule you for an appointment. If you notice that your blood glucose is above 125 and we have not scheduled a follow-up appointment, please call us. Patients who are known diabetics can have readings greater than 125.
Urea Nitrogen: This is a kidney function and maybe elevated because of mild dehydration or because of excessive muscle breakdown from aggressive exercise habits.
Creatinine: This also is a kidney function test. It may be mildly elevated if you have particularly large muscle bulk or taking a supplement like creatine. It is related to the GFR. It is a muscle product that we track to look at your kidney function. If this is elevated and new, we may need to talk with you. If you have had this mildly elevated in the past, it is likely that we will just track it to ensure that it does not worsen quickly. Some medications may gently worsen this, namely blood pressure pills called ace inhibitors. To some degree, we will permit levels of up to 1.6.
Sodium: This is essentially the concentration of salt within the body. This may be mildly low because of dehydration or diuretics.
Potassium: This is an electrolyte that can cause muscular cramping or cardiac difficulties. It is sometimes lowered by diuretic medications.
Chloride: For the most part, this is only relevant if the other electrolytes are abnormal.
CO2: This is a function of acid balance within the body. For the most part, mild abnormalities are not important and may represent a starvation or dehydration state when blood was drawn.
Anion Gap: Only relevant if your CO2 is abnormal.
Calcium: This is not related to dietary intake of calcium. It may fluctuate gently based on the amount of protein within your body. If it is above 10.9, we may need to do additional testing.
Total protein: This looks at protein within the body. Markedly elevated levels can represent an immune response and may require further workup.
Albumin: This may be elevated because of particularly high level of fitness. If it is markedly suppressed, it may represent organ dysfunction, particularly in the liver or kidneys.
AST: This is a liver function test. For the most part, we tolerate minor elevations of 2-3 times the upper limit (80-120). This is particularly true for cholesterol medicines called statins. If it is elevated in the absence of significant alcohol intake, we may need to do additional workup. If your AST level is elevated and you drink alcoholic beverages, I would strongly encourage you to reduce or stop consuming alcoholic beverages.
ALT: This is also a function of the liver, see above.
Alk Phos: Part of liver function; elevated levels may indicate a liver injury or obstruction of bile flow.
Total Bilirubin: This is also part of liver function; elevated levels may indicate a liver injury or obstruction of bile flow.
Thyroid Stimulating Hormone (TSH): This reading is an indicator of your thyroid function. The thyroid regulates energy levels throughout the entire body, affecting almost every organ system. This is an inverse relationship so a high number actually presents a low thyroid. If this is abnormal, we will often check an additional lab called a Free T4 to evaluate this more carefully. Borderline elevations, those of 5-10, can be watched or worked up further.
Prostate Specific Antigen (PSA): (Men only.) This is a prostate cancer screening test, and is no longer a routine screening test. Levels are truly a function of age. Being less than 4 is typical for someone more in their 60s. If you are young, it should probably be less than 3. A higher PSA result does not necessarily mean that you have cancer, but may indicate a need for a discussion with your provider. Options include observation to look at rate of rise or prostate biopsy. Not only is the absolute value important, but how much it has changed from previous years. Please ensure that there is not a dramatic rise from previous years.
Vitamin D: This is a popular vitamin to observe right now. Vitamin D is primarily absorbed from the sunlight through the skin, and less so absorbed by the body from dietary sources (eggs, mushrooms, and fish among others). If this is low, particularly in the summertime, you may need to consider supplementing your vitamin D as discussed with your provider. Decreased vitamin D levels have been implicated in everything from fatigue to muscle aches, and from depression to dementia.
Total Testosterone: An optional lab checked in males to look for a low testosterone involved in poor energy, vitality or sexual dysfunction. The normal range varies with your age. As one might expect, 500 is more typical in a 20 year old and 250 is more typical in somewhat later in life in their 60-70s. If this is low, you may need to have discussions with your provider.
CK: This is a muscle enzyme typically checked either if you have muscle aches or if you are on a cholesterol medicine called a statin. Mild elevations may represent good exercise habits, some muscle breakdown or it may represent ongoing inflammation of the muscles.
Culture, Urine: It is common to have minor contaminant from poor collection. If it is less than 50,000 cfu, usually this is not deemed clinically relevant. If you do have an infection, you will see that they give the name of the bacteria that is involved. They will also give which antibiotics are sensitive (S) or resistant (R).
Lipase: This is a blood test that looks for pancreatic inflammation, a common problem of epigastric pain or nausea. Elevations may need additional workup.
Magnesium: This is an electrolyte associated with muscle cramping or heart rhythm disturbances. Low levels need to be supplemented.
Sedation Rate (ESR): Known as a 'sed rate'. If the rate is elevated above 30-40, it can represent infection, inflammation or neoplastic process. This lab is commonly used to check for fatigue, arthritis, headaches or body aches.