Blood Tests Demystified

What those lab numbers mean for your
cardiovascular well-being.


February 2013

By Lisa James

They can’t uncover every potential health hazard, but blood tests can provide useful information about your well-being, both now and in the future. That includes factors that increase cardiac risk, some known for decades (such as high glucose levels) and some more recently discovered (such as chronic inflammation).

The following guide (using lab results from a hypothetical patient) focuses on blood tests that monitor not only your heart but also your liver, an organ vital to glucose and cholesterol metabolism. (Other tests, such as red and white blood counts, that are generally part of a standard workup aren’t included here; note that some reference ranges may vary between labs and with other factors, including health status.)

1

C-Reactive Protein (CRP)

A marker of inflammation in the blood. Long used to track inflammation levels after injuries, infections and other acute events, mildly elevated CRP is now known to be associated with cardiovascular disorders, including coronary events, stroke, high blood pressure and type 2 diabetes. Reference Range: <1.0 mg/L, low risk; 1.0-3.0, average risk; 3.1-10.0, high risk; >10, check for other health problems

2

Hemoglobin A1c

A marker of glucose levels over the previous two to three months. It measures the amount of glycated hemoglobin, which is formed when hemoglobin in the blood is exposed to glucose over time. This test is used to see how well someone with diabetes is controlling their blood sugar.
It is also used to help determine if diabetes is present and has been associated with a greater risk of cardiovascular disease. Reference Range: <5.7, decreased diabetes risk; 5.7-6.4, at risk for diabetes; >=6.5, consistent with a diagnosis of diabetes

3

Metabolic Panel

A variety of tests used to help diagnose conditions such as diabetes, kidney disease and liver disease (liver tests are covered separately in Section 5). Fasting glucose levels are used (along with hemoglobin A1c and other tests) to help determine the presence of diabetes, a disorder often symptomless in its earliest stages; symptoms that may develop include increased thirst and urination, fatigue and blurred vision. Glucose levels that fall between the normal and diabetic ranges indicate the presence of prediabetes, also referred to as impaired fasting glucose. The other four tests shown here measure levels of electrolytes, crucial to bodily functions that involve electrical activity, such as nerve impulses and heartbeat, as well as maintaining proper fluid balance and pH levels. (Other tests in this panel include calcium, albumin, total protein, blood urea nitrogen (BUN) and creatinine.) Reference Ranges for tests shown: glucose—65-99 mg/dL, normal; 100-125, prediabetes; 126 on more than one test, diabetes; sodium—135-146 mmol/L; potassium—3.5-5.3 mmol/L; chloride—98-110 mmol/L; carbon dioxide—21-33 mmol/L

4

Lipid Panel

Tests that measure various types of fats, or lipids, in the blood. The first three items shown all measure cholesterol, which for transport in the blood is packaged with protein to form lipoproteins. Low density lipoprotein (LDL), or “bad” cholesterol, is the type that may form arterial plaque
when it is oxidized, a process similar to metal rusting. High density lipoprotein (HDL) has always been considered the “good” cholesterol, acting as a tow truck to bring LDL back to the liver for processing. However, research published last year in The Lancet found that people with naturally higher HDL levels have no less heart disease than those with slightly lower levels; researchers are debating what this means in terms of how “good” HDL really is. (Total cholesterol is the sum of LDL, HDL and other types of lipoprotein.) The fourth item shown here is triglycerides; high levels are believed to make LDL more plaque-forming and to make blood more likely to clot. (Some researchers believe the current level of triglycerides considered desirable should be revised downward.) Other tests may also be ordered including LDL size, which determines if LDL particles are the large, buoyant A type, less likely to lodge in blood vessel walls, or the small, dense, problematic B type. Reference Ranges for tests shown: LDL-C—<130 mg/dL, desirable (<100 for cardiovascular disease and/or diabetes); 130-159, borderline high; 160-189, high; >=190, very high; HDL-C—<40, low; >=60, high; total cholesterol—<200, desirable; 200-239, borderline high; >=240, high; triglycerides—<150, desirable; 150-199, borderline high; 200-499, high; >=500, very high

5

Liver Function

Tests that monitor liver health. Among its many other functions, the liver breaks down and repackages proteins, fats, including blood lipids, and carbohydrates, including glucose and a glucose storage molecule called glycogen. The liver also uses cholesterol to create a fat-digesting substance called bile, which helps draw cholesterol out of the bloodstream. Bilirubin is a waste product disposed of by the liver and ALP, AST and ALT are liver enzymes. Levels of all four generally rise in response to liver dysfunction; other tests may be ordered as needed. Reference Ranges for tests shown: bilirubin—0.2-1.2 mg/DL; ALP—33-130 U/L; AST—10-35 U/L; ALT—6-40 U/L

 

BLOOD HEALTH SUPPLEMENTS

Artichoke Helps protect liver cells and stimulate bile production; contains a form of fiber called fructans that has shown cholesterol-lowering capabilities
Bilberry A blueberry relative that contains circulation-enhancing compounds; may help control glucose levels in type 2 diabetes; best known for supporting eye health
Cayenne May help blood vessels dilate, which improves blood flow; appears to positively influence the heart’s rhythm and pumping capacity
CoQ10/Ubiquinol Helps tissues generate energy, especially cardiac muscle; helps keep blood from clotting abnormally; has shown an ability to fight metabolic syndrome, a heart disease precursor
Fish/krill oil
Both contain omega-3 fatty acids, long associated with greater cardiovascular health; krill oil has been linked to reductions in cholesterol and inflammation
Folate/B6/B12 Work together to reduce levels of homocysteine, a protein metabolism byproduct linked to cardiovascular disease; all are needed to support overall blood health
Garlic Long used in traditional medicine systems around the world; contains phytonutrients that fight atherosclerosis; helps reduce cardiovascular risk
Grape Seed Helps keep blood from clotting abnormally; may help reduce triglyceride levels; serves as a potent antioxidant
Green Tea Consumption associated with reductions in heart attack risk; may improve blood vessel function; has been linked to reductions in body fat, a cardiovascular risk factor
Hawthorn Traditionally used as a cardiac remedy in European herbalism; may help control blood pressure, prevent atherosclerosis and relieve heart failure symptoms
L-Carnitine Has improved survival when added to heart failure, angina and post-heart attack treatment regimens; has improved exercise tolerance in people with poor circulation in the legs
Magnesium Optimizes blood flow by promoting healthy blood vessel dilation; helps the heart pump properly
Milk Thistle Long history of use as a liver remedy; contains silymarin, which fights inflammation in, and supports detoxification of, the liver
Niacin Helps control levels of LDL cholesterol and triglycerides; may help prevent cardiac events in people with atherosclerosis
Plant Sterols Inhibits cholesterol absorption within the intestines, lowering blood levels
Pycnogenol Has been associated with healthy changes in blood pressure, platelet function, and glucose and blood lipid levels
Resveratrol/D Both nutrients, especially when taken together, help to improve cardiovascular health parameters and retard aging
Vitamin E Increased consumption has been linked to reduced risk of heart attack and heart disease mortality

NOTE: Discuss the specific blood tests you should go for with your practitioner, taking factors such as age and gender, as well as your own unique health profile, into account. Supplementation should be supervised by a healthcare provider, especially if you are currently taking prescription medication.

 

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