Trends on basic laboratory tests

After years of analyzing many different labs, I’ve realized that many diagnoses have patterns that can be appreciated even on basic laboratory tests -- such as a comprehensive metabolic panel, CMP and complete blood count with differential, CBC w/ diff.

On this BLOG, we will cover the patterns you can identify on basic labs of the following conditions:

• Digestive Inflammation

• Oxidative Stress

• Bacterial and Viral Infections

  • Acute

  • Chronic

• Vitamin B12 deficiency

•  Folate deficiency

Patterns of digestive inflammation

Basic laboratory tests such as a comprehensive metabolic panel, CMP and complete blood count with differential, CBC w/ diff that can indicate digestive inflammation.

Even if you have “normal” inflammatory markers, I always look to see if there are any patterns like the ones below to see if we need to do further, in-depth digestive testing.

The patterns of digestive inflammation:

👆High (or normal): MCV, MCH, total globulin, BUN, basophils

👇Low: total protein, albumin, phosphorus, hematocrit, hemoglobin

Even if I find these patterns with the basic lab tests, I always follow up with advanced stool testing so we can be 100% sure.

However, this really helps me prioritize which tests are more important so we can make sure that you are investing your money wisely into lab tests!

Patterns of oxidative stress

Without running advanced labs, you can often see patterns of oxidative stress / free radicals.

Tests such as a comprehensive metabolic panel, CMP and complete blood count with differential, CBC w/ diff can indicate patterns of oxidative stress.

The patterns of oxidative stress:

👆High (or normal): LDL, uric acid, total globulin, bilirubin, ferritin, platelets

👇Low: lymphocytes, albumin, HDL (also ASK the question have your total cholesterol always been low, or has something recently changed)

After identifying oxidative stress, I use the history and any pattern in the CMP associated with poor digestion and additional inflammatory markers to hone in on the source(s) of the oxidative stress to decide if further specialized testing is warranted versus implementing a plan of care based on the suspected root cause. 

The patterns of viral and bacterial infections (acute and chronic)

With basic laboratory tests such as a comprehensive metabolic panel, CMP and complete blood count with differential, CBC w/ diff, you can identify the patterns of acute infections.

The patterns of viral infections:

▶︎Acute Viral Infections

👆High: White Blood Cells, ESR, Bands, & during the recovery phase monocytes may go up as well. 📌The biggest difference is an elevated lactate dehydrogenase

👇Low (or normal): neutrophils

▶︎Chronic Viral Infections

👆High: Serum iron (total >100)

👇Low: WBC goes down (<5), lymphocytes

The patterns of bacterial infections:

▶︎Acute Bacterial Infections

👆High: White Blood Cells, neutrophils, ESR, Bands, & during the recovery phase monocytes may go up as well

👇Low (or normal): lymphocytes

▶︎Chronic Bacterial Infections

👆High: Serum iron (total >100)

👇Low: WBC goes down (<5), neutrophils

Since many of the things overlap with both bacterial and viral infections, it’s always important to check a patient’s history. The next step is then to utilize that history and symptom report to identify where that infection may be hiding and what type of infection it may be so the appropriate next tests can be ordered, such as a comprehensive stool study, a vaginal culture, a urinary culture, throat or nose culture, or viral antibody testing. Working with a specialist here is very important as there are many nuances to integrating the history with the labs, there are also special circumstances such as those with autoimmune diseases, those on medications such as prednisone or immune modulating medications that will influence these test results and impact what the individual will benefit most from in their next steps in their healing journey. 

Patterns of B12 or folate  deficiency

It’s possible to identify Vitamin B12 or folate deficiency WITHOUT running a B12 or folate test.

Through analyzing a series trends on basic laboratory tests such as a comprehensive metabolic panel, CMP and complete blood count with differential, CBC w/ diff you can often uncover a Vitamin B12 or folate deficiency.

The patterns of B12 or folate deficiency:

👆High: MCH, MCV, RDW, serum iron, LDH

👇Low: RBC, hematocrit, hemoglobin, WBC, neutrophil, uric acid

When this pattern exists my next step is to order the appropriate red blood cell concentration test or organic acid test for the urinary byproducts of B12 and folate, Methylmalonate and Formiminoglutamate to be certain about deficiency and the degree of deficiency prior to starting treatment. The amount of folate needed to correct a deficiency can vary drastically from one person to another, it is for this reason I suggest you work with a functional medicine specialist to stay safe. 

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Now it’s your turn! Grab your most recent labs and cross-compare your labs!

If you identified any of those patterns, book a FREE 15-min health discovery call with me, so that we can discuss the best way to put you on the right track to optimal health!